To effectively implement "Technical manual of clinical blood transfusion ",ensure the safety of clinical blood transfusion,and decrease nursing human resources cost,a nursing station for blood delivery hospital was established. This paper introduces the environment and facility,basic setup of information-based management,organizational structure,operation and management mode of nursing station for blood delivery. With flexible work mode,standard distribution process,safe and timely distribution,and effective quality control of blood transfusion process,the nursing station for blood delivery ensured the safety and effectiveness of clinical blood utilization,strictly implemented "Technical manual of clinical blood transfusion ",made full use of human resources,relieved the stress of laboratory technicians of blood transfusion department,and improved the satisfaction rate of medical staff towards blood transfusion department.

Objective To investigate the pathogenic bacteria and drug resistance in orthopedics patients, so as to guide the clinical use of antibiotics.Method708 secretions and pus samples from orthopedic outpatients and inpatients were cultured aerobically.The detectable bacteria were subjected to drug sensitivity test in vitro by the K-B assay.Result259 pathogenic strains were detected, and 47.9% of them were Gram-positive (Staphylococcus aureus, 33.0%: coagulase-negative staphylococci, 14.9%),and the remaining 52.1% were Gram-negative (Pseudomonas, 7.3%; Acinetobacter, 6.1%). The drug-resistant rate of Gram-positive cocci to penicillin and oxcillin tended to raise over the three years : however, all the detected Gram-positive cocci were sensitive to vancomycin (100%).Most Gram-negative bacilli were sensitive to imipenem (95.8%) in the past three years and the sensitivity to ceftazidime was also high; however, the sensitivity tended to fall over the past three years. The drug-resistant rates of Gram-negative bacilli to CiprofIoxacin. amikacin and piperacillin were 46.0%. 47.0% and 51.2% respectively.ConclusionGram-negative bacilli dominate the pathogenic bacteria in orthopaedic patients and they tend to increase. The incidence of infections by Gram-positive cocci is lower than that of infections by Gram-negative bacilli. In terms of individual bacteria ,staphylococcus aureus leads among all of these pathogenic bacteria, Vancomycin, Oxacillin and Norfloxacin are preferred drugs against Gram-positive cocci, while imipenem and ceftazidime are preferred for Gram-negative bacilli.The incidence of infections by Gram-negative bacilli tend to raise and drug resistance of Gram-negative bacilli becomes serious:hence, it is crucialOto emphasize the detection of infectious bacteria and drug sensitive test and to use antibiotics rationally.

Objective To analyze the effect and the problems of the comprehensive application of quality management tools in order to improve nursing quality and ensure patient safety.Methods To summarize the implementation of Plan,Do,Check,Action(PDCA),quality control circle(QCC),root cause analysis(RCA),healthcare failure mode and effect analysis(HFMEA) in the nursing quality improvement.Aiming at problems arising in application process,the measures such as systematic training of quality management knowledge,case demonstration,standardized evaluation throughout the whole process,holding competition activities,inviting experts to give immediate guidance were applied.Results Among 1 798 PDCA and QCC programs,the result of 1 795 programs reached the target value,3 substandard programs reached the expected outcome finally after cause analysis,procedure break down and adjust of improvement contents.No nursing error or adverse events occurred.The indicators of nursing quality improved and patient satisfaction was 98.58％,which got the third position among all national hospitals.Conclusions The comprehensive application of four quality management tools was helpful in enhancing the effect of nursing quality improvement.

Objective To investigate the distribution of scopolamine into brain following intranasal .Methods Adult Wistar rats were divided into two groups ,and administrated with scopolamine 0 .3 mg via intraperitoneal or intranasal respectively .Two groups of blood concentration and brain concentration of scopolamine were determined by solid phase extraction (SPE) and LC/MS assay at the time point of 5 ,10 ,20 ,30 ,60 ,120 ,240 ,480 min ,and their kinetic parameters were calculated and compared .Results Scopol-amine bioavailability of intranasal administration was 65% ,and the maximum concentration of scopolamine in brain following in-tranasal administration was much higher than that following intraperitoneal administration .Comparing the ratio of AUC in brain and in plasma ,ratio of intranasal administration is bigger than that of intraperitoneal administration significantly (P<0 .05) .Con-clusion It was concluded that scopolamine′s intranasal administration induced the agent targeting distribution into the brain .

Objective To investigate the effects of preconditioning with ω-3 polyunsaturated fatty acid (ω-3 PUFA) on the second liver injury in rats with traumatic brain injury and hemorrhagic shock (TBIS) and explore the underlying mechanism.Methods Total of 36 male Wistar rats were assigned randomly (random number) into 3 groups (n =12 in each):sham operation group (C),TBIS model group and PUFA pretreatment group.The arterial blood samples were taken for determination of serum levels of ALT,AST and TNF-α.The liver were removed for determination of levels of superoxide dismutase (SOD),malondialdehyde (MDA) and glutathione (GSH),and microscopic examination.Results Compared with group C,the serum levels of ALT,AST and TNF-α and the liver levels of MDA were significantly higher (P ＜0.01),but the liver levels of SOD and GSH in group TBIS and group PUFA were significantly lower (P ＜0.01).The serum levels of ALT,AST and TNF-α and the liver levels of MDA were significantly lower (P ＜ 0.01 or P ＜ 0.05),but the levels of SOD and GSH in liver tissues were significantly higher (P ＜ 0.01or P ＜ 0.05) in group PUFA than those in group TBIS.Histological examination revealed the injury of liver in TBIS group,and the rats in PUFA treated group showed alleviated severity of liver injury.Conclusions The supplementation of ω-3 PUFA can ameliorate acute liver injury in rats with TBIS,which may contribute to inhibition of oxygen free radicals and inflammatory cytokines expression.

Objective To investigate the effects of ω-3 polyunsaturated fatty acids (ω-3 PUFA) on inflammatory response of intestine and bacteria translocation in rats with traumatic shock (TS) in order to explore the underlying mechanism.Methods A total of 36 male Wistar rats provided by Academy of Military Medical Sciences Animal Center were assigned randomly (random number) into 3 groups (n =12 in each group):sham operation group,TS model group and PUFA pretreatment group.Rat models of IS were established by comminuted fracture of femur and depletion of blood,and 2 mg/kg ω-3 PUFA or normal saline were injected 12 hours and 2 hours before modeling.Blood specimens were collected and intestinal tissue samples were obtained 120 min after modeling.The serum levels of tumor necrosis factor-o (TNF-α),IL-1β,IL-10 and 8-iso-prostaglandin F 2α (8-iso-PGF2α) were measured with ELISA.Light microscopic examination was carried out for histopathological assessment of the intestina tissue and the intestinal mucosa damage index ( IMDI ) was calculated.The number of marked bacilli found in mesenteric lymph nodes,lung,liver,spleen,and kidney tissues were counted under a fluorescent microscope.The percentages for categorical variables and mean ± SD for continuous variables were expressed. Chi-square test and unpaired t-test were used for comparisons among groups,and statistical significance defined as P ＜ 0.05.Results The levels of TNF-α,IL-1β,IL-10 and 8-iso-PGF2α,the IMDI and the positive rates of bacteria translocation in TS model group were [ (325.14 ±21.17) ng/ml,(26.93 +2.58) μg/L,(7.59 ± 1.26) μg/L,(259.73 +61.32) pg/ml,(4.15 +0.37) and 58.33％,respectively] and those in PUFA group were [ (251.47 + 19.16) ng/ml,(17.81±1.94) μg/L,(9.44±1.85) μg/L,(171.44±39.25) pg/ml,(3.28±0.43) and 36.67％,respectively ].And those biomarkers in both TS group and PUFA group were higher obviously than those in sham group [ (37.02 ±5.54) ng/ml,(2.49 ±0.67) μg/L,(2.93 ±0.74) μg/L,(81.26 ± 15.18) pg/ml,(0.33 ±0.12) and 6.67％,respectively,P＜0.01].Compared with TS model group,the levels of TNF-α,IL-1β and 8-iso-PGF2α,the IMDI and the positive rates of bacteria translocation were lower,and the levels of IL-10 were higher in PUFA group ( P ＜ 0.01 or P ＜ 0.05 ).Conclusions The supplementation of ω-3 PUFA lessens the injury of intestina mucosa after traumatic shock,and it may be associated with the inhibition of inflammatory response by intestine and bacteria translocation.was carried out for histopathological assessment of the intestina tissue and the intestinal mucosa damage index ( IMDI ) was calculated.The number of marked bacilli found in mesenteric lymph nodes,lung,liver,spleen,and kidney tissues were counted under a fluorescent microscope.The percentages for categorical variables and mean ± SD for continuous variables were expressed. Chi-square test and unpaired t-test were used for comparisons among groups,and statistical significance defined as P ＜ 0.05.Results The levels of TNF-α,IL-1β,IL-10 and 8-iso-PGF2α,the IMDI and the positive rates of bacteria translocation in TS model group were [ (325.14 ±21.17) ng/ml,(26.93 +2.58) μg/L,(7.59 ± 1.26) μg/L,(259.73 +61.32) pg/ml,(4.15 +0.37) and 58.33％,respectively] and those in PUFA group were [ (251.47 + 19.16) ng/ml,(17.81±1.94) μg/L,(9.44±1.85) μg/L,(171.44±39.25) pg/ml,(3.28±0.43) and 36.67％,respectively ].And those biomarkers in both TS group and PUFA group were higher obviously than those in sham group [ (37.02 ±5.54) ng/ml,(2.49 ±0.67) μg/L,(2.93 ±0.74) μg/L,(81.26 ± 15.18) pg/ml,(0.33 ±0.12) and 6.67％,respectively,P＜0.01].Compared with TS model group,the levels of TNF-α,IL-1β and 8-iso-PGF2α,the IMDI and the positive rates of bacteria translocation were lower,and the levels of IL-10 were higher in PUFA group ( P ＜ 0.01 or P ＜ 0.05 ).Conclusions The supplementation of ω-3 PUFA lessens the injury of intestina mucosa after traumatic shock,and it may be associated with the inhibition of inflammatory response by intestine and bacteria translocation.

Objective To investigate the effects of ω-3 polyunsaturated fatty acid (ω-3 PUFA) on acute lung injury (ALI) in a rat model of traumatic shock. Methods Thirty-six male Wistar rats aged 3 months were randomly assigned into 3 groups ( n = 12 each): control group (group C) ; traumatic shock group (group TS) and ω-3 PUFA + TS group (group to-3 PUFA) . Traumatic shock was induced by fracture of femur and hemorrhage according to the method described by Feeney in groups TS and ω-3 PUFA. In group ω-3 PUFA, ω-3 PUFA 2 ml/kg was injected via the caudal vein at 12 and 2 h before induction of traumatic shock. Arterial blood samples were taken at 120 min after traumatic shock was successfully induced for determination of serum concentrations of TNF-α, IL-1β, IL-10 and 8-iso-PGF2α by ELISA. The animals were then sacrificed and lungs were removed for-determination of W/D lung weight ratio and microscopic examination. Results Traumatic shock significantly increased serum concentrations of TNF-α, IL-1β, IL-10 and 8-iso-PGF2α, W/D ratio and pathologic scores of lung tissues in groups TS and ω-3 PUFA as compared with group C.ω-3 PUFA significantly attenuated traumatic shuck-induced increase in serum concentrations of TNF-α, IL-1β and 8-iso-PGF2α , W/D ratio and pathologic scores of lung tissues but further increased the serum IL-10 concentration in group ω-3 PUFA as compared with group TS. Conclusion ω-3 PUFA can significantly inhibit the svstemic inflammatory response and ameliorate traumatic shock-induced ALI.

Objective To investigate the effects of ω-3 polyunsaturated fatty acids (ω-3 PUFA) on systemic inflammatory response and intestinal mucosa barrier in rats with traumatic brain injury and hemorrhagic shock (TBIS).Methods A total of 36 male Wistar rats were equally randomized into 3 groups:sham operation group,TBIS model group,and ω-3 PUFA pretreatment group.The serum levels of tumor necrosis factor-α (TNF-α),8-iso-prostaglandin F2 a (8-iso-PGF2 a),interleukin (IL)-1 β,and IL-10 were measured by enzyme linked immunosorbent assay (ELISA).HE staining was performed for morphological assessment of the intestinal tissue and evaluation of the intestinal mucosa damage index (IMDI).The marked bacilli of the mesenteric lymph nodes,lung,liver,spleen,and kidney tissue were counted under a fluorescent microscope.Results Compared with those in the sham group [ (38.15 ± 6.37) ng/ml,(84.91 ± 17.22) pg/ml,(2.52 ± 0.83 ) μg/L,(2.86 ± 0.82) μg/L,0.36 ±0.14,and 8.33％ ],the serum levels of TNF-α [ (328.11 ±20.09) and (244.37 ±21.82) ng/rrl],8-iso-PGF2a [ (263.47±55.19) and (176.35±41.63) pg/ml],IL-1β [ (27.06±2.61) and (18.91 ±1.78) μg/L],IL-10 [ (7.63 ± 1.29) and (9.52 ± 4.66) μg/L],the IMDI (4.18 ±0.39 and 3.31 ±0.40),and the positive rates of bacterial translocation (56.67％ and 35.00％ ) were significantly higher in both the TBIS model group and ω-3 PUFA group ( all P ＜ 0.01 ).Compared with TBIS model group,the levels of TNF-α,8-iso-PGF2 a,and IL-1 β,the IMDI,and the positive rate of bacterial translocation were significantly lower ( all P ＜ 0.05 ) and the levels of IL-10 were significantly higher in the ω-3 PUFA group (P ＜0.01 ).Conclusion The supplementation of ω-3 PUFA can remarkably inhibit the systemic inflammatory response and protect the integrity of intestinal mucosa in rat with TBIS.

ObjectiveTo investigate the effects of ω-3 polyunsaturated fatty acid (PUFA) preconditioning on liver injury in a rat model of traumatic shock.MethodsForty-eight male Wistar rats aged 3 months weighing 240-260 g were randomly divided into 4 groups ( n =12 each): sham operation group (group S) ; group S + ω-3 PUFA; traumatic shock group (group TS) and group TS + ω-3 PUFA.In groups S + ω-3 PUFA and group TS + ω-3 PUFA,ω-3 PUFA 2 ml/kg was injected via the caudal vein at 12 and 2 h before induction of traumatic shock.In groups S and TS,normal saline was given instead of ω-3 PUFA.Traumatic shock was induced by fracture of femur and hemorrhage in groups TS and TS + ω-3 PUFA.The arterial blood samples were taken at 2 h after induction of traumatic shock for determination of serum activities of ALT,AST and concentrations of 8-iso-prostagiandin F2,(8-iso-PGF2α) and TNF-α.The liver was removed for determination of levels of SOD and MDA,glutathione (GSH)and microscopic examination.ResultsCompared with group S,the serum ALT,AST,8-iso-PGF2α and TNF-α levels and MDA content in the liver tissues and score of liver injury were significantly increased,but the liver tissues levels of SOD,GSH were decreased in groups TS and TS + ω-3 PUFA( P ＜ 0.01 ).Compared with group TS,the serum ALT,AST,8-iso-PGF2α and TNF-α levels and MDA content in the liver tissues and score of liver injury were significantly decreased,but SOD activity and GSH content in the liver tissues were increased in group TS + ω-3 PUFA( P ＜ 0.05 or 0.01 ).Conclusionω-3 PUFA preconditioning can reduced liver injury in a rat model of traumatic shock through inhibiting lipid peroxidation and inflammatory reaction.

Objective To evaluate the neurotoxic effects of intrathecal (IT) different concentrations of ethanesulfonic acid ropivacaine on spinal cord in rats. Methods Sixty healthy Wistar rats of both sexes weighing 210-220 g in which IT catheters were successfully placed according to Yaksh et al. were randomly divided into 5 groups (n= 12 each). The animals received 0.9% NaCl solution 0.4 ml (group C); 0.224%, 0.447%,0.671%, 0.894% ethanesulfonic acid ropivacaine 0.4 ml (group R1-4 ). The onset time and duration of the block were recorded. The animals were killed on 7th day after IT administration. The L4,5 segment of the spinal cord were removed for neuropathologic examination with electron microscope. The spinal cord injury was scored.Neurotoxicity was defined as the spinal cord injury score ≥ 2 and the spinal neurotoxicity was recorded. Results Onset time was shorter and duration of the block was prolonged with increasing concentrations of ethanesulfonic acid ropivacaine. The incidence of the spinal neurotoxicity was 0, 0, 17%, 42% and 100% in group C, R1, R2, R3 and R4 respectively. The incidence of the spinal neurotoxicity was gradually increased with increasing concentrations of ethanesulfonic acid ropivacaine. Conclusion IT ethanesulfonic acid ropivacaine can produce neurotoxicity to the spinal cord and it depends on the concentration.