OBJECTIVE To introduce and discuss the quality management system of medical loaner instrumentation and implantables in the US.METHODS With US national standards and industry guidelines on loaner instrumentation and implantables,and the practical problems we encountered in China on this subject,we will discuss their quality management.RESULTS We should apply whole process quality management to loaner instrumentation and implantables.CONCLUSIONS Zero tolerance quality management in loaner instrumentation and implantables is crucial for medical safety.

OBJECTIVE To compare three surgical hand preparations for their effects on hand skin conditions.METHODS Three surgical hand antisepsis methods were selected to compare their immediate antimicrobial(efficacies) and effect on skin conditions,including 1% chlorhexidine gluconate(CHG)and 61% ethanol(pre-surgical) waterless,scrubless hand preparation,iodophor surgical scrub with sponge,and iodophor surgical scrub with brush.RESULTS All of the three methods could achieve satisfying immediate reduction in the normal(bacterial)(flora) of the hands.The alcohol-based surgical hand rub method was gentler to skin than the other two.(CONCLUSIONS) The alcohol-based surgical hand rub is recommended for surgical hand antisepsis.

The carotid initima-media thickness(CIMT)in 78 cases of type 2 diabetic patients was measured.The level of plasma endogenous secretion receptor for advanced glycation end-products(esRAGE)in patients with normal CIMT was higher than those with chickened CIMT[(0.257 3±0.165 6 vs 0.155 4±0.0701)μg/L,P<0.01].esRAGE was negatively associated with CIMT(r=-0.247,P<0.05).Logistic regression analysis showed that CIMT was negatively associated with esRAGE and hish density lipoprotein cholesterol,but was positively associated with age.

OBJECTIVE:To observe therapeutic efficacy and safety of cefoperazone sodium and sulbactam sodium combined with Shenmai injection in the treatment of elderly stroke associated pneumonia(SAP). METHODS:A total of 84 SAP patients in Dazhou Municipal Central Hospital during Mar. 2016-Mar. 2017 were divided into control group(42 cases)and observation group (42 cases)according to random number table. Based on routine treatment,control group was additionally given Cefoperazone sodium and sulbactam sodium for injection 3 g added into 5% Glucose injection 100 mL,intravenously,twice a day;suitable antibiotics were selected according to the results of pathogenic examination and drug sensitivity test. Observation group was additionally given Shenmai injection 100 mL added into 5% Glucose injection 250 mL intravenously,once a day,on the basis of control group. Both groups were treated for consecutive 2 weeks. Clinical efficacies of 2 groups were observed,and the levels of T-lymphocyte subsets(CD4+,CD8+,CD4+/CD8+)and inflammatory markers(TNF-α,hs-CRP,PCT),length of hospital stay before and after treatment. The ADR was recorded. RESULTS:The total response rate(95.24%)and marked response rate (47.62%)of observation group were significantly higher than those of control group(83.33%,23.81%);length of hospital stay in observation group [(15.24±3.53)d] was significantly shorter than control group [(18.43±4.21)d],with statistical significance (P<0.05).After treatment,the levels of CD4+and CD4+/CD8+in 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group;the levels of CD8 +,TNF-α,hs-CRP and PCT in 2 groups were significantly lower than before treatment;the observation group was significantly lower than the control group,with statistical significance(P<0.05);there was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Based on routine treatment,cefoperazone sodium and sulbactam sodium combined with Shenmai injection treat SAP significantly,can effectively improve immune function, reduce inflammation level and shorten the length of hospital stay without increasing the occurrence of ADR.

Objective To explore the effect and mechanism of microRNA (miR)-17-5p on the invasion and metastasis of hepatocellular carcinoma (HCC) cells. Methods Expression of miR-17-5p in the normal human L-02 hepatocyte and QGY-7703 HCC cells was detected by RT-PCR. QGY-7703 HCC cells were transfected by miR-17-5p mimic and mimic control respectively. Influence of miR-17-5p on the invasion and metastasis ability of HCC cells was detected using Transwell assay and scratch test. Target gene of miR-17-5p was confirmed by bioinformatic analysis, and its expression in HCC cells was detected by Western blot. After siRNA silenced by target gene, the invasion and metastasis ability of HCC cells were observed. Comparison of microRNA in the two kinds of cells was conducted by t test. Results Expression level of miR-17-5p in HCC cells was 0.16±0.04, significantly lower than 1.01±0.19 in normal L-02 hepatocytes (t=-9.67, P<0.05). Number of trans-membrane cells and metastasis rate of HCC cells transfected by miR-17-5p mimic were respectively 36±4 and (5.37±0.15) mm/d, significantly lower than 62±7 and (7.50±0.01) mm/d of control group (t=-15.40, -32.00; P<0.05). Bioinformatic analysis showed that AKT3 was the key target gene of miR-17-5p, and the expression of AKT3 in HCC cells was obviously higher than that of normal hepatocyte. Number of trans-membrane cells and metastasis rate of HCC cells transfected by siRNA-AKT3 were respectively 13±3 and (4.13±0.15) mm/d, significantly lower than 58±3 and (7.23±0.25) mm/d of control group (t=-17.88, -53.69; P<0.05). Conclusion miR-17-5p inhibits the invasion and metastasis ability of HCC cells through targeting effect on AKT3.

Objective To identify risk factors for seroma formation and to explore the related prevention and treatment methods.Methods We collected clinical and pathological data of 92 breast cancer patients undergoing modified radical mastectomy in Hu'nan Provincial People's Hospital,from January to September 2016.Seroma formation was studied in relation to age,tumor size,nodal involvement,the number of lymph nodes removed,flap fixation and external compression dressing.Count date were evaluated by the frequency and percentage,comparison between the groups was analyzed by the chi-square test.Multivariate analysis was performed using Logistic regression analysis.Results Seroma occurred in 45.7％ of patients.Age,tumor size,nodal involvement,the number of lymph nodes removed,flap fixation were risk factors of modified radical mastectomy postoperative seroma.In multivariate logistic regression analysis an association of postoperative seroma formation was noted with the number of lymph nodes removed(OR =1.123,95％ CI:1.036-1.218,P ＜ 0.01),age(OR =1.060,95％ CI:1.006-1.116,P＜0.05),flap fixation(OR=0.363,95％CI:0.135-0.977,P ＜0.05).Conclusion The findings suggest that older patients,with extensive lymph node dissection may more likely to form postoperative seroma,flap fixation can reduce the incidence of seroma.

BACKGROUND:Material biomechanics is the investigation of the mechanical microenvironment of biomaterials through a material science approach,which belongs to the frontier discipline of sustainable development. OBJECTIVE:To explore the current research hotspots and development trends of material biomechanics and provide theoretical references for subsequent research. METHODS:Based on CiteSpace bibliometric software,we generated keyword co-occurrence and clustering,emergent word detection,and other knowledge maps based on 3 182 material biomechanics literature in the Web of Science core database during 2012-2022 for visualization analysis. RESULTS AND CONCLUSION:The number of research articles on the biomechanics of materials has been increasing in the last decade,and the United States,China,and Germany are the top three countries in terms of the number of articles published,and the research is mainly concentrated on major universities and research institutions,with significant aggregation.Material biomechanics research mainly involves the disciplines of material science,biomedical engineering,and kinesiology.Finite element analysis,material properties,mechanical performance of biomaterials,and molecular biomechanics are the focus of scholars'attention and research.At present,the research in the field of material biomechanics focuses on the use of finite element analysis to calculate the mechanical response of different biomedical materials under different conditions of loading and mechanical properties for the prevention of sports diseases,surgical planning,and postoperative rehabilitation.The application of inorganic materials and the mode of transport of molecular signals may be the prospect of future research.