Objective To discuss the application effect of health care failure mode and effect analysis in quality control of polysomnngraphy.Methods The health care failure mode and effect analysis were applied to analyze the process of polysomnngraphy,process reengineering was carried out according to potential risk factors and causes affecting the results of polysomnography in order to ensure the continuous improvement of quality of polysomnography.Results After the improvement of the key link affecting the quality of polysomnography,the number of the patients underwent polysomnography increased from 345 in 2007 to 657 in 2010,the success rate increased from 93％ to 98％ and the doctors' trust level about polysomnography increased from 90％ to 96％.Conclusions Applying the health care failure mode and effect analysis to analyze of key link affecting the quality of polysomnography prospectively and adopting the pertinent countermeasures can effeetively improve the quality of polysomnngraphy.

Animals ; Carcinogenesis ; Cell Cycle Proteins ; genetics ; metabolism ; Cyclin E ; metabolism ; F-Box Proteins ; genetics ; metabolism ; F-Box-WD Repeat-Containing Protein 7 ; Gene Silencing ; Genes, Tumor Suppressor ; Humans ; Mutation ; Myeloid Cell Leukemia Sequence 1 Protein ; metabolism ; Neoplasms ; genetics ; metabolism ; pathology ; Proto-Oncogene Proteins c-myc ; metabolism ; Receptors, Notch ; metabolism ; Signal Transduction ; TOR Serine-Threonine Kinases ; metabolism ; Ubiquitin-Protein Ligases ; genetics ; metabolism

Objective To investigate the relationship between high-sensitive C-reactive protein(hsCRP)and insulin resistance(IR)in elderly hypertension patients.Methods The levels of ambulatory blood pressure mo- nitoring(ABPM),fasting plasma glucose(FPG),fasting insulin(FINS),von Willebrand factor(vWF),hsCRP were measured in elderly patients with hypertension alone(n=260),hypertension coexit with diabetes(n=230), and healthy matched subjects(n=250).Results The levels of FINS,FPG,vWF,hsCRP,systolic blood pres- sure(SBP),diastolic blood pressure(DBP)in the HT and HT+DM group were significantly higher than that in the NC group(P

Air Pollutants, Occupational ; analysis ; Chromatography, Gas ; methods ; Indenes ; analysis ; Workplace

Adult ; Aged ; Cervical Intraepithelial Neoplasia ; pathology ; surgery ; Cervix Uteri ; pathology ; surgery ; Conization ; methods ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; methods ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm, Residual ; pathology ; surgery ; Uterine Cervical Neoplasms ; pathology ; surgery

BACKGROUND:Polyvinyl alcohol(PVA)has similar water content as human tissues,good biocompatibility and high mechanical strength,thereby being utilized as tissue-engineered matrix material.However,the modification in cellular affinity benefits the function as tissue regeneration scaffold materials.OBJECTIVE:To prepare chitosan(CS)/PVA composite scaffold and explore the feasibility of serving as a scaffold for tissue engineering.METHODS:Scaffolds of CS/PVA was fabricated by blending PVA-124 with various amounts of CS using film forming,particle forming,and free-drying methods.Water content,light transmittance,and swelling ratio were tested.Scanning electron microscope was used to observe the configuration of the cross section.RESULTS AND CONCLUSION:A total of 7 different proportional scaffolds were obtained with different PVA and CS dosage.The composite film showed light transmittance between 70%-80%,high water content between 121.2%-162.5% and swelling ratio between 60.3%-133.7%.Composite particle and sponge obtained water content between 82.0%-461.2% and 280.8%-1 939.0%.Composite scaffold with the amount ratio of PVA 0.75 g/CS 0.15 g exhibited the best performance.Scanning electron microscope showed that at a mass ratio of PVA 0.75 g/CS 0.15 g,the scaffold prepared by freeze-drying method had regular,fluffy inner structure,with good mechanics and high water content.

Objective To evaluate the clinical outcomes of treating Freiberg's disease with dorsal wedge osteotomy and Charlotte breakage screw fixation.Methods From June 2010 to June 2014,11 patients with Freiberg's disease were treated at our department.They were 5 males and 6 females at an average age of 32 years(range,from 15 to 52 years).X-ray revealed osteosclerosis and collapse of the metatarsal head.According to Smillie classification system,there were 5 cases of stage Ⅱ and 6 ones of stage Ⅲ.The duration of symptoms was from 7 to 48 months (average,23 months).The metatarsal heads were rotated to reconstruct the joint surface.After dorsal closed V-shaped osteotomy,Charlotte breakage screws were implanted.Results All wounds healed with no complications in the early postoperative period.The 11 patients were followed up for 14 to 48 months (average,19 months),showing obvious pain relief.X-ray showed that the osteotomy sites got solid union in all patients at an average time of 10 weeks (range,from 8 to 13 weeks) after operation.Average shortening of the metatarsal was 1.5 mm (range,from 1.1 to 1.8 mm).The American Orthopaedic Foot and Ankle Society(AOFAS) score,Lesser Metatarsophalangeal-Interphalangeal Scale(LMIS) score,and range of motion at one day,one month and one year after operation were significantly improved compared with the preoperative ones (P ＜ 0.05).Significant differences were also observed between all postoperative time points (P ＜ 0.05).No such complications happened as referred pain from the adjacent metatarsophalangeal joint,displacement,nonunion,necrosis or infection.All patients returned to sports and recreational activities at 6 months after operation,except one case of stage Ⅲ who had constant swelling in the metatarsophalangeal joint but eventually recovered at 10 months after operation.According to patients' satisfaction at the last follow-ups,including 7 cases were excellent,3 good and one poor.Conclusion Dorsal closed V-shaped osteotomy with Charlotte breakage screw fixation is an effective procedure for Freiberg' s disease of stages Ⅱ and Ⅲ,because it leads to effective reconstruction of the metatarsophalangeal joint,allows early joint motion and avoids a second operation.

In view of risk characteristics of surgical site infection,the risk factors of the infection were graded and classified while the risk indicators system and risk assessment matrix for surgical site infection were built,based on literature analysis,integrated use of documents analysis,Delphi method and risk quantification matrix.The study indicated that surgical skills of the surgeon and surgical time length are the most important risk factors,followed by insufficient maintenance of the operating room environment and poor baseline assessment of the patient.Risk control of surgical site infection needs to focus on these key factors,optimize utilization of resources and improve the prevention and control ability of surgical site infection.

BACKGROUND: Polyvinyl alcohol (PVA) has similar water content as human tissues, good biocompatibility and high mechanical strength, thereby being utilized as tissue-engineered matrix material. However, the modification in cellular affinity benefits the function as tissue regeneration scaffold materials. OBJECTIVE: To prepare chitosan (CS) / PVA composite scaffold and explore the feasibility of serving as a scaffold for tissue engineering. METHODS: Scaffolds of CS/PVA was fabricated by blending PVA-124 with various amounts of CS using film forming, particle forming, and free-drying methods. Water content, light transmittance, and swelling ratio were tested. Scanning electron microscope was used to observe the configuration of the cress section. RESULTS AND CONCLUSION: A total of 7 different proportional scaffolds were obtained with different PVA and CS dosage. The composite film showed light transmittance between 70%-80%, high water content between 121.2%-162.5% and swelling ratio between 60.3%-133.7%.Composita particle and sponge obtained water content between 82.0%-461.2% and 280.8%-1 939.0%. Composite scaffold with the amount ratio of PVA 0.75 g/CS 0.15 g exhibited the best performance. Scanning electron microscope showed that at a mass ratio of PVA 0.75 g/CS 0.15 g, the scaffold prepared by freeze-drying method had regular, tluffy inner structure, with good mechanics and high water content.

Aim The changes of the levels of blood sugar and plasma insulin in obese woman pa-tients with insulin resistance and the effect of insulin intravenous infusion during oper-ation were observed. Methods 10 patients of normal weight(contrast group, group A)and 20 patients of obesity women(ASA grade Ⅰ- Ⅱ) undergoing selective surgerywere investigated. The patients of obesity were randomly divided into two groups(group B and C, respectively). Groups A and B liquids without glucose, and in group Ctransfuse liquids with glucose and insulin(4g glucose add 1U insulin) were transfusedduring operation. The levels of blood sugar and plasma insulin were measured beforeand after anesthesia, during operation(30min) and after operation respectively. ResultsThere was an insulin resistance phenomenon in patients with obesity. The levels ofblood sugar and plasma insulin in patients with obesity were remarkably higher thanthose in patients of normal weight. The levels of blood sugar and plasma insulin wereextremely raised after anesthesia and during operation. The levles of blood sugar wasinhibited as insulin was infused during operation, but no hypoglycemic reaction wasfound. Conclusion There are insulin resistance phenomenon in patients with obesity.Insulin infused during operation can prevent blood sugar rise and minimize glucosemetabolism turbulence.