Objective To investigate cervical screening procedure in routine physical examinations.MethodsA retrospective study was carried out to assess the procedures and outcomes of cervical cancer screening among women receiving physical examinations in our hospital from October 2008 to September 2009.ResultsA total of 11 542 women underwent gynecological examinations .Of them,13.55% only received TCT,6.60% finished TCT+HPV screening.The positive detection rate of TCT+HPV screening was higher than TCT alone(x2=15.87,P＜0.05).Conclusion Cervical cancer screening rate may be low.

Objective To explore the impacts of natural ovulation cycles and stimulation cycles on the outcome of intrauterine insemination (IUI) in order to improve the clinical effects of IUI. Methods 176 women received 384 stimulation cycles. According to different ovulation stimulation protocols , the women were divided into six groups including natural cycle (NC) group, clomiphene citrate (CC) group, letrozole (LE) group;human menopausal gonadotrophin (HMG ) group, CC + HMG group, and LE + HMG group. The pregnancy rate between nature cycles and ovarian hyperstimulation cycles was compared. Results The pregnancy rate was 9.33%in the nature cycle group and 13.27% in the stimulation cycle group, with a significant difference (P < 0.05);and it dif not differ significantly among the stimulation cycle groups (P > 0.05). Conclusions Use of ovulation-induction medications is one of the important factors affecting the pregnancy rate of intrauterine insemination. There are no differences in the outcome of IUI among different ovulation stimulation protocols.

Objective To explore the effect of pre-filled catheter flushing device on the sealing of venous indwelling needle. Methods One hundred and sixteen patients with venous indwelling needle were assigned into observation group, in which pre-filled catheter flushing device was used to seal the needle tube and another 109 with venous indwelling needle as control group, in which the needle tube was sealed with 50U/mL heparin saline.The two groups were compared in terms of blockage of the tube, phlebitis, catheter-associated infection, indwelling time of the needle and time for nurses to seal it.Results The rates of blockage of catheter, phlebitis and catheter-associated infection of the observation group were all lower than those of the control group.The indwelling time of the needle was significantly longer than that in the control group.The time for nurses to seal the catheter was significantly shorter than that in the control group(all P<0.05). Conclusion Pre-filled catheter flushing device can reduce complication rate and improve working efficiency of nurses.

Objective To investigate the incidence and the prognosis of acute kidney injury (AKI) and to find out the risk factors associated with the outcome for better understanding and preventing AKI among inpatients. Methods All the hospitalized patients were screened by Lab Administration Network of Renji Hospital,Shanghai Jiaotong University School of Medicine from Jan.to Dec.2009.Study cohort was comprised of all the patients with AKI defined by Acute Kidney Injury Network (AKIN) and with complete clinical data recorded.The incidence,etiology and distribution characteristics, prognosis of AKI in hospitalized patients were retrospectively analyzed.Logistic regression analysis was used to investigate the risk factors of patients and renal outcome. Results A total of 934 patients with AKI were enrolled.The incidence of AKI in hospitalized patients was 2.41％ (934/38 734).The ratio of male to female was 1.88∶1.Age was (60.82±16.94) years old.Increasing incidence could be seen with age rising.There was 63.4％ AKI found in surgical department,35.4％ in internal medicine department and 1.2％ in obstetric and gynecologic department.Pre-AKI,acute tubular necrosis (ATN),acute glomerular and renal vascular injury (AGV),acute interstitial nephritis (AIN) and post-AKI were accounted for 51.7％,37.7％,3.8％,3.5％ and 3.3％ of the causes of AKI,respectively.On day 28,the survival rate was 71.8％,complete renal recovery rate was 65.7％,partial renal recovery rate was 16.9％ and renal loss rate was 17.4％ among all the patients with AKI.The mortality of AKI with stage Ⅰ,Ⅱ and Ⅲ among inpatients was 24.8％,31.2％ and 43.7％ respectively.Multivariate Logistic regression analysis showed that renal injury drugs [odds ratio (OR)=2.313],hypotension (OR=4.482),oliguria (OR =5.267),the number of failure organs except kidney (OR =1.376) and requiring renal replacement therapy (RRT)(OR=4.221) were independent risk factors for death among AKI patients.The number of failure organs except kidney (OR=1.529) and RRT (OR=2.117) were independent risk factors for kidney loss. Conclusions AKI is one of the most common complications in hospitalized patients.The mortality is high and renal outcome is poor after AKI.The prognosis is closely associated with the severity of AKI.Renal injury drugs,hypotension,oliguria,the number of failure organs except kidney and requiring RRT are independent risk factors for death among AKI patients,while the number of failure organs except kidney and requiring RRT are independent risk.factors for renal loss.

In order to investigate the effect of chitosan/pshR.NA plasmid nanoparticles targeting MDRI genes on the resistance of A2780/TS cells to paclitaxel,chitosan/pshRNA plasmid nanoparticles were synthesized by means of a complex coacervation technique and transfected into A2780/TS cells.The cells transfected with MDR1-targeted chitosan/pshRNA plasmid nanoparticles were experimental cells and the cells transfected with chitosan/pGPU6/GFP/Neo no-load plasmid nanoparticles served as negative control cells.Morphological features of the nanoparticles were observed under transmission electron microscope (TEM).MDR1 mRNA expression was assessed by RT-PCR.Half-inhibitory concentration (IC50) of paclitaxel for A2780/TS cells was determined by MTT method.TEM showed that the nanoparticles were round-shaped,smooth in surface and the diameters varied from 80 to 120 nm.The MDR1 mRNA in the transfected cells was significantly decreased by 17.6%,27.8% and 52.6% on the post-transfection day 2,4 and 7 when compared with that in A2780/TS cells control (P<0.05).MTT assay revealed that the relative reversal efficiency was increased over time and was 29.6%,51.2% and 61.3% respectively in the transfected cells 2,4,7 days after transfection and IC50 (0.197±0.003,0.144±0.001,0.120±0.004) were decreased with difference being significant when compared with that in A2780/TS (0.269±0.003) cells control (P<0.05).It was concluded that chitosan/pshRNA plasmid nanoparticles targeting MDR1 can effectively reverse the paclitaxel resistance in A2780/TS cells in a time-dependent manner.

Objective To investigate the factors affecting the efficacy of leflunomide combined with medium/low dose corticosteroids in the treatment of progressive IgA nephropathy (IgAN).Methods Clinical and pathological parameters were collected retrospectively in patients of primary IgAN with proteinuria＞ 1.0 g/24 h and chronic kidney disease (CKD) stage 1-3 treated with leflunomide combined with medium/low dose corticosteroids in Ren Ji Hospital,School of Medicine,Shanghai Jiao Tong University from Jan 2005 to Dec 2010.According to the treatment effects,patients were divided into complete remission group and non-complete remission group.The biochemical and pathological indexes of the two groups were compared.Results A total of 42 patients were included.The remission rates at 3,6,9 and 12 months were 62％,64％,67％ and 74％,respectively.Seventeen (40.5％) and fourteen (33.3％) patients achieved complete and partial remission after one-year treatment,and the remission rate remained stable within one year after withdrawal of drugs.The 24hour proteinuria was 1.50 (0.67,2.66) g,which was significantly reduced compared with the baseline 2.44 (1.36,3.74) g (P ＜ 0.01).The decrease rate was 31.3％.There was a slight decrease in proteinuriawithin one year after withdrawal of drugs.Estimated glomerular filtration rate (eGFR) remained stable during the treatment and a year of follow-up.No serious adverse event was observed during the followup period.Among 31 responder patients,6(19.4％) patients relapsed.Logistic multivariate regression analysis suggested that the degree of renal interstitial inflammatory infiltration was an independent predictor of complete remission with one-year treatment of leflunomide combined with medium / low dose corticosteroids (HR=0.067,95％ CI 0.008-0.535,P=0.011).Conclusions IgAN treated with leflunomide and medium/low dose corticosteroids can achieve remission in early stage,and the remission rate remains stable after withdrawal of drugs.It is a safe option for the treatment of IgAN.Renal interstitial inflammatory infiltration is an independent predictor of complete remission.

Objective To explore the application of Plan-Do-Check-Act(PDCA)cycle management to continuously im-prove the service quality of outpatient pharmacy and enhance patient satisfaction.Methods To address the problem of long wait-ing time for patients in outpatient pharmacy,we applied PDCA cycle to investigate the factors affecting patients'waiting time in the process of medicine collection,analyze the current situation,determine the expected goals,formulate the service quality im-provement plan of outpatient pharmacy,implement the improvement plan,follow up and supervise,and summarize and analyse the problems regularly until it was solved.Results After implementing the PDCA cycle in the management,the service quality of outpatient pharmacy was improved,the waiting time was significantly shortened and the satisfaction of medical treatment was in-creased.Conclusion The application of PDCA cycle method is effective in improving the service quality of outpatient pharmacy.Therefore,it is recommended for broader implementation.

Preventing and mitigating major risk exposure is an important task for modern countries to maintain sustained and healthy economic development and overall social stability. In this manuscript, the authors introduced Israel′s current medical and health care risk prevention system, including the regional health emergency response coordination mechanism, hospital′s external emergency rescue capacity building and hospital′s internal security system. Israel′s risk prevention system has been tested by wars and terrorist attacks, as well as many infectious diseases outbreaks. Thus the authors expected that its successful experiences can be introduced as a reference for improving China′s medical and health care risk prevention system.