Objective Describes the use of homemade simple bedside bracket of children supracondylar fracture closed reduction and percutaneous pin fixed surgical methods and clinical effects.Methods 16 cases of children supracondylar fractures Gartland type Ⅱ cases,15 cases Gartland type Ⅲ,13 males and 3 females,with an average age of 6 years old,all patients used our hospital homemade simple bedside shelf assisted closed reduction,percutaneous pin fixation,and fixed with plaster immobilization.Results 16 patients were followed-up,in addition to the two cases of pin tract infection,fracture all were healed smoothly.Without iatrogenic nerve injury and internal fixation loosening,and also no volkmann contracture,and myositis ossificans etc complications.The average fracture healing time for three weeks,no bone delayed union or nonunion occurred.According to Flynn clinical function evaluation,there were excellent in 7 cases,good in 9 cases.Conclusion Useing homemade simple bedside shelf to children supracondylar fractures closed reduction and percutaneous Kirschner wire fixed can ensure the efficacy,and also simplify the surgical procedure,reduce radiation intake,which is the worthy of clinical practice.

Objective To investigate whether mixed venous-arterial carbon dioxide difference (Pv-aCO2) combined with passive leg raising (PLR) could better guide volume management for patients post off-pump coronary artery bypass grafting (OPCABG).Methods Eighty patients experienced OPCABG, and admitted to Tianjin Chest Hospital from June 1st to October 1st in 2016 were enrolled. They were randomly divided into two groups: observation group given Pv-aCO2 combined with PLR directed therapy and control group given central venous pressure (CVP) directed therapy, 40 cases in each group. The difference in body temperature (T), heart rate (HR), mean arterial pressure (MAP), CVP, oxygenation index (PaO2/FiO2), mixed venous oxygen saturation (SvO2), Pv-aCO2, blood lactate (Lac), fluid intake, scores of the vasoactive agents at 6 hours post-operation, sequential organ failure assessment (SOFA) of 24 hours, mechanical ventilation time, the length of intensive care unit (ICU) stay, and hospitalization time were compared. The correlation between Pv-aCO2 and cardiac index (CI), Pv-aCO2 and Lac were analyzed by Spearman analysis in observation group.Results The T, HR, MAP, CVP, PaO2/FiO2, SvO2 and Lac at 6 hours post-operation were higher than those at admission in two groups, and Pv-aCO2 were significantly decreased. The SvO2 and fluid intake in observation group were higher than those in control group [SvO2: 0.671±0.068 vs. 0.634±0.052, fluid intake (mL): 454±151 vs. 304±106, bothP < 0.05], Pv-aCO2, Lac and scores of the vasoactive agents were lower than those in control group [Pv-aCO2 (mmHg, 1 mmHg = 0.133 kPa): 6.1±1.8 vs. 7.0±1.8, Lac (mmol/L): 1.7±0.5 vs. 2.8±0.6, scores of the vasoactive agents: 3.18±1.01 vs. 4.48±1.50, allP < 0.05], mechanical ventilation time and the length of ICU stay were less than those in the control group (hours: 16.52±6.41 vs. 21.96±9.00, 45.51±9.36 vs. 51.76±13.66, bothP< 0.05). There was no significant difference in SOFA, hospitalization time between the two groups. There was negative correlation with Pv-aCO2 and CI (r = -0.752,P < 0.01), and no correlation with Pv-aCO2 and Lac (r = -0.154,P = 0.171).Conclusion Pv-aCO2 combined with PLR can better guide volume management in the patients post OPCABG, reduce the usage of vasoactive agents and decrease the mechanical ventilation time and the length of ICU stay.

ObjectiveIn order to study the effect of three-month rehabilitation on motor function in hemiplegics after stroke. Methods125 patients were randomly divided into two groups, rehabilitation group (72 cases)and control group(53 cases).Patients in the rehabilitation group were given clinical treatment,electric stimulation therapy(EST) and regularly physical therapy, while those in control group were given clinical treatment and unguided self-training, and the evaluation was done in pre-treatment and post-three-month respectively. Motor function was assessed in Fugl-Meyer Assessment(FMA).ResultsMotor scores in each group had a more significant difference(P<0.001)before and after treatment, the process of scores in the rehabilitation group was obviously superior to that in the control group(P<0.001). Conclusions Rehabilitation training on hemiplegics after stroke may obviously improve motor function, depressing the disability and increasing the living quality.

Objective To quantifying the urine human cytomegalovirus(HCMV)DNA from the HCMV infection infants and its corresponding liver function indications,and investigate the relationship between their concentrations.Methods The u-rine samples were collected from HCMV infection infants.HCMV DNA was measured by fluorescence quantitative polymer-ase chain reaction (FQ-PCR).Serum ALT,AST,ALP,GGT,T-Bil and D-Bil liver function indications were detected and the positive rate was analyzed,simultaneously.The correlation between the logarithm urine HCMV DNA (log HCMV DNA) concentration and ALT,AST,ALP,GGT,T-Bil and D-Bil were analyzed by Spearman correlation analysis.Results The dis-tribution range ofurine log HCMV DNA in 444 HCMV infection infants was <2.70~7.90;the positive rate of serum ALT, AST,ALP,GGT,T-Bil and D-Bil were 24.8%,59.0%,95.7%,31.1%,16.7% and 16.3%,respectively.The urine log HC-MV DNA was associated with GGT and the correlation coefficient was 0.099 (P < 0.05),but no associated with ALT, AST,ALP,T-Bil and D-Bil.Conclusion The positive rate of liver function indications will rise in HCMV infection infants, the urine log HCMV DNA was associated with GGT,but not associated with other liver function indications.

Objective:To systematically evaluate the risks of anti-TNF-αtreatment-associated infection, severe infection and tuberculosis in rheumatoid arthritis (RA) patients, and to reduce the infection incidences associated with anti-TNF-αtherapy. Methods:We used Meta analysis to systematically review randomized controlled trials on anti-TNF-αtreatment associated risks of infecion, severe infection and tuberculosis in AR patients.Results:Although no statistically significant differences were detected in TB risk between anit-TNF-αtreatment and the control group (0.5%vs 0.07%;P=0.27, OR=1.85, 95%CI:0.62-5.52), there still existed a clinically obvious elevation of TB risk in monoclonal anti-TNF-αtreatment, which was illustrated by the results that no TB case was reported in the etanercept group, but 11 TBs in 2050 infliximab-treated cases, and 3 TBs in 722 adalimumab-treated cases. The total infection and severe infection risks were also signiifcantly higher in patients receiving anti-TNF-αtreatment (P<0.05). Subanalysis revealed that etanercept showed no signiifcantly higher infection or severe infection risk than control group (P>0.05), while both kinds of monoclonal antibodies of TNF-αblockers showed a signiifcantly elevated infection or severe infection risks (P<0.05). High doses of anti-TNF-αtreatment were associated with statistically increased risks of severe infection (6.0%vs 2.8%, P=0.04, OR=1.68, 95%CI:1.02-2.78). Conclusion:The TB risk of anti-TNF-αtreatment deserves close attention, especially in places with high rate of BCG vaccination and MTb infection. Monoclonal anti-TNF-αtreatment brings higher risks of infection and severe infection than soluble TNF-αreceptor.

Objective To study the clinical significance and diagnostic value of anti-proliferating cell nuclear antigen (PCNA) antibodies.Methods A retrospective analysis was conducted for the diagnoses and clinical features of 102 patients with anti-PCNA antibodies.Line immunoassay was used to detect anti-PCNA antibody of 536 systemic lupus erythematosus (SLE) patients.Possible relationship between anti-PCNA anti-body and clinical features and other antibodies in SLE were analyzed.Comparisons between groups were performed by t-test or x2 test.Results In the 102 patients with anti-PCNA antibodies,49 had SLE (48.0％).Other disorders associated with anti-PCNA antibodies included primary Sj(o)gren's syndrome(24.5％),systemic sclerosis (12.7％),primary biliary cirrhosis (3.9％),auto-immune thyroiditis (6.9％),polymyositis/dermatomyositis (2.0％) and hepatitis C virus infection (1.0％).9.1％ of SLE patients showed positive anti-PCNA antibody.Compared with those SLE patients with negative anti-PCNA antibody,the occurrences of rash,neuropsychiatric SLE,renal involvement was significantly higher in the anti-PCNA positive patients.In addition,the SLEDAI score was significantly higher in the latter.The positive rates of anti-Rib-P,anti-dsDNA,anti-Ro52,anti-RNP/Sm were higher in patients of SLE with positive anti-PCNA antibody.Conclusion Sera anti-PCNA antibody is not specific for SLE and it is associated with the occurrences of rash,Raynaud's phenomenon,neuropsychiatric SLE,renal involvement and positive rates of anti-Rib-P,anti-dsDNA,antiRo52,anti-RNP/Sm.In addition,anti-PCNA antibody is associa-ted with the disease activity of SLE.

Objective To explore application effects of the tracking management mode in outpatient rescue vehicles. Methods From June 2015 to July 2016 Ningbo First Hospital of Zhejiang Province applied the tracking method to track the whole process of drugs in rescue vehicles in the outpatient care unit and the quality of the equipment section. According to the tracking results, improvement measures were made and implemented in time. The first-aid medicine in rescue vehicles, the quality of item management, the time of checking rescue vehicles and the nurses′ satisfaction degree with the use of rescue vehicles were compared between before and after the implementation of the tracking management mode. Results After the implementation of the tracking management mode, the average score of the first-aid medicine in rescue vehicles and the quality of item management was( 99.12±0.88) points. The time of checking rescue vehicles was (11.24 ±1.42) min. The nurses′ satisfaction degree of using rescue vehicles was ( 98. 37 ± 1. 63 ) points. Before the implementation, they were (95.56±1.51)points,(18.00±2.51) min and(93.37±2.24) points, respectively. The differences of scores were all significant before and after the implementation of the tracking management mode (t=7.344,8.751,6.508;P<0.01). Conclusions The application of the tracking management model improves the first-aid medicine in outpatient rescue vehicles and the quality of item management, reduces the nurses′time of checking rescue vehicles and improves the nurses′ satisfaction degree with the use of rescue vehicles.

ObjectiveTo explore the application of the management by wandering around (MB-WA) model in the management of outpatient service,listen to the nurses and patients in the outpatient service,induct nurses to pay attention to the nursing quality,enhance the collaboration awareness of nurses,improve the quality of nursing and the satisfaction of patients.Methods The MB-WA model was implemented from January 2016. According to the clinical nursing quality control score table,nursing managers went to the clinical line,handed out the outpatient satisfaction questionnaire,found out the problems in the clinical nursing,promptly formulated and implemented measures to consolidate the quality of improvement.Results After the implementation of the MB-WA model in 2016,the scores of triage nursing quality (96.27±0.69),nursing etiquette (98.33±1.31), nursing operation (96.97±1.26),management of emergency medicine instrument (99.36±0.44),and patient satisfaction (91.11±2.56) increased when compared to the scores before the implementation in 2015 [(95.10±1.08),(95.31±1.24),(95.47±1.15),(95.56±1.51) and (81.15±4.68)]. The differences were statistically significant (P<0.05).Conclusions The ME-WA model help the managers to directly access the clinical problems,provide timely and targeted interventions,achieve the goal of the cooperation of nurses, participate the outpatient management,increase the outpatient management quality and management level of managers,and improve the service quality.

Objective To explore the effects of patient-participating nursing mode in improving the nursing quality for chemotherapy patients in day-care ward. Methods A total of 80 cases of chemotherapy patients in the Day-care Ward of Ningbo First Hospital from April to September 2017 were selected and randomly divided into control group and observation group, with 40 patients in each group. Routine nursing care was applied in the control group. On the basis of routine nursing, patient-participating nursing mode was applied in the experimental group. The safety of intravenous chemotherapy (venous exudation and phlebitis), patient satisfaction and quality of life of the two groups were observed and compared. Results The incidences of phlebitis, venous exudation and patient satisfaction of the control group were 22.5%, 5.0% and 80.0% respectively. Those of the observation group were 15.0%, 0% and 97.5% respectively, and the differences were statistically significant (P< 0.05). After the application of patient-participating nursing mode, the patients in the observation group were superior to the control group in their overall condition, body, role, cognition, emotion and social support. The scores of fatigue, insomnia, loss of appetite, diarrhea and constipation were lower than those of the control group, and the differences were statistically significant (P<0.05). There were no statistical differences in the incidences of nausea and vomiting, pain and shortness of breath (P> 0.05). Conclusions Patient-participating nursing mode is conducive to improve the safety and effectiveness of intravenous chemotherapy, reduce the adverse reactions of chemotherapy, and improve patient satisfaction and quality of life to some extent.

Objective: To investigate the peak time and peak area of elements in cadmium telluride quantum dots (CdTe QDs) using size exclusion chromatography-high-performance liquid chromatography-inductively coupled plasma mass spectrometry, as well as the biological stability of CdTe QDs in vivo and in vitro. Methods: Transmission electron microscope and ultraviolet fluorescence were used for characterization and synthesis of water-soluble CdTe QDs, and CdTe QDs were added to double-distilled water, mobile phase, or bovine serum medium to observe the change in stability after different periods of time. CdTe QDs were injected into the vein of mice, and the changes in the morphology of CdTe QDs in serum and the liver were measured at 1, 24, and 72 hours after exposure. Size exclusion chromatography-high-performance liquid chromatography was used for the elution of the compounds in the solution based on their volume, and then inductively coupled plasma mass spectrometry was performed for the eluent. The flow time of ¹¹⁴Cd and ¹³⁰Te and molar ratio were used for qualitative analysis of CdTe QDs, and the peak area was used to judge whether CdTe QDs were degraded. Results: CdTe QDs were diluted to a concentration of 0.5 mmol/L with double-distilled water and then placed in a dark place at room temperature; CdTe QDs were completely degraded after 60 minutes. CdTe QDs were diluted to a concentration of 0.005 mmol/L with a mobile phase, and the peak of CdTe QDs was not detected. After CdTe QDs were placed in a dark place at room temperature for 48 hours at a concentration of 0.005 mmol/L in bovine serum mediumin vitro, the peak area of ¹¹⁴Cd was 6179841-7346084, and the peak area of ¹³⁰Te was 1077913-1191066. CdTe QDs had the highest peak area at 1 hour after exposure, and the peak areas of ¹¹⁴Cd and ¹³⁰Te were 18183894 and 25187987, respectively. CdTe QDs were quickly degraded in the liver; at 1 hour after exposure, the degradation products of CdTe QDs containing Cd were observed in liver tissue homogenate, and CdTe QDs were largely degradedat 24 hours. Conclusion This method can be used to investigate the biological stability of CdTe QDs. CdTe QDs are degraded in the liver and produce Cd²⁺, which may cause toxic reaction.