Objective:To explore the combined application effect of failure mode and effect analysis (FMEA) and root cause analysis (RCA) in IV infusion risk management of pediatric outpatient so as to enhance the quality of care and ensure the safety of outpatients.Methods: For this exploration, a special analysis team was established and the flowchart was drawn up, and the potential failure modes were listed by using FMEA. And the RCA was used to analyze and evaluate the key mode in these potential failure modes so as to find the root cause might affect the safety of IV infusion, and then the improved measures were implemented and the effects of new measurement were evaluated. Results:After implemented the improved measures, the risk of top 4 risk priority number (RPN) in intravenous infusion flow decreased obviously. For the transfusion management, patients' satisfaction increased from 78.09% to 95.03% (P<0.05), and nurses' satisfaction increased from 83.79% to 97.80%(P<0.05).Conclusion: The combined application of FMEA and RCA in the IV infusion risk management of pediatric outpatient can effectively reduce the occurrence of risk events, reduce nursing complaints and disputes, and enhance the quality of nursing care.

Objective This investigation was to define the occupational security-related factors in community nurses and effective strategies to improve their service awareness and occupational protection ability.Methods A questionnaire was used for 1702 community nurses in Guangzhou to learn occupational security-related factors and occupational protection skills.Results Self-report results found that 21.3% (362/1702) nurses fully understood the occupational security-related factors,12.0% (204/1702) nurses knew the requirement for occupational security,and 12.3% (209/1702) nurse could provide occupational protection.Conclusions These results suggested that most community nurses showed poorer occupational protection awareness and ability.Thus,occupation safety management regulations,standardized performance procedure and emergency response plan should be put forward,and further community nurse training programme need to be initiated.

Objective To study the rule with the treatment based on the pattern differentiation of systemic lupus erythematosus, by analyzing the literature of traditional Chinese medicine for the treatment of systemic lupus erythematosus from January 1999 to July 2014 included in China National Knowledge Infrastructure(CNKI) and summarizing the frequency of TCM pattern and medicine.Methods The frequency statistics and classified analysis were used to describe the patterns and medicines.Results There were 14 patterns, the common patterns are pyretic toxicity with 23(15.13%), deficiency of both qi and yin with 21(13.82%), qi and blood stasis with 20(13.16%). The disease was involved with liver, spleen and kidney. Pattern factors were mainly sthenia factors, accounting for 65.30% of the total, including hot, blood stasis, toxin, damp-heat, qi stagnation, phlegm; asthenia factors were accounted for 34.70% of the total, including deficiency of yin, deficiency of qi, deficiency of yang and deficiency of blood. There were 201 medicines included, the total frequency was 1 669, which could be into 17 categories. The top three were heat-clearing, tonic and stasis-dissolving medicines. Medicine tropisms are mainly lung tropism, stomach tropism, liver tropism, heart tropism, spleen tropism and kidney tropism, accounting for 88.12% of the total.Conclusions Pyretic toxicity is responsible for the sthenia factors of systemic lupus erythematosus, and deficiency of qi and yin is the main responsibility for asthenia factors, treatment should pay attention to both sthenia and asthenia factors.

Objective To investigate nursing interns’knowledge and attitude towards needle stick injury before clinical practice.Methods In 20-23 June,2015,nursing interns who were about to start clinical practice in a hospi-tal were investigated,nursing interns’knowledge and attitude towards needle stick injury were surveyed through questionnaire.Results A total of 350 questionnaires were distributed,324 (92.57%)responded questionnaires were available.40(12.35%)questionnaires were responded by male interns,and 284(87.65%)were by female in-terns;34(10.49%)interns had bachelor degree;the mean age of interns were (20.83 + 1 .24)years old.The correct answer rates about questions related to injury occurring during needle recapping and wearing gloves were low (about 60%).About 70% of the interns gave the correct answers to questions about hepatitis B infection due to needle stick injury following hepatitis B vaccination,as well as medication after injury.Score for individual question about attitude towards needle stick injury was ≤3,the major related problems were susceptibility of blood borne diseases and recapping needles.Conclusion Needle stick injury-related knowledge and attitude among nursing interns is inadequate,including recapping needles,timely report,susceptible to infectious diseases,and so on.It is necessary for schools and teaching hospitals to strengthen the education about occupational protection among nursing interns, so as to improve the attitude and ability of professional protection.

Objective To investigate the effects of ultraviolet irradiation on the morphology, cell proli-feration, mutation frequency and level of expression of ATP mRNA in human fibroblasts. Methods The infant foreskin fibroblasts were cultured and irradiated with different doses of ultraviolet A or B (UVA or UVB). Light microscopy was used for observing the morphologic change and cell counting of cell proliferation, HPRT-mutagenesis assay for the mutation detection, and RT-PCR for the expression of ATP mRNA. Results Compared with the control group, the irradiated cultured fibroblasts were damaged, cell growth was retarded (MTT assay showed 2.4 fold increase in the control group but only 0.2 fold in the UVB group 72 h after irradiation). Mutation frequency in 106 colony forming cells was increased from 20.4 ? 6.7 at 20 mJ/cm2 to 97.7 ? 7.1 under 60 mJ/cm2 of UVB irradiation. The expression level of ATP mRNA was down-regulated after UV irradiation. There was an increase of mutation frequency which was UVB dose-dependenct, and decrease of ATP mRNA expression which was dose- and time-dependent. Conclusions After UV irradiation of the cultured fibroblasts, the cell damage and growth inhibition are induced, and the mutation frequency is increased in a UVB dose-depen-dent maaner. The expression of ATP mRNA shows down-regulation in both dose- and time-dependent manner.

Objective To observe the analgesic effects of dexmedetomidine combined with dif-ferent-doses of sufentanil in patients undergoing spine surgery.Methods Sixty patients(ASA grade Ⅰor Ⅱ degree,age 18-70 years)undergoing spine surgery were randomly assigned into three groups ac-cording to PCA formulation(n =20):3 μg/kg sufentanil group (group S1),1.5 μg/kg dexmedetomi-dine+ 2 μg/kg sufentanil group (group S2 )and 1.5 μg/kg dexmedetomidine + 1 μg/kg sufentanil group (group S3).The same anesthesia method was applied among three groups.Patient-controlled intravenous analgesia pump was applied before 30 minutes prior to the end of surgery.The drugs in each group were diluted to 1 50 ml and infused by a pump at a rate of 3 ml/h with a patient-controlled analgesia (PCA)bolus of 0.5 ml and lock time of 30 minutes.VAS and Ramsay scores at 2 h(T0 ),4 h (T1 ),8 h(T2 ),12 h(T3 ),24 h(T4 )and 48 h(T5 )after surgery were estimated.Postoperative nausea and vomiting,bradyrhythmia and hypersomnia were also recorded.Results Compared with group S1, VAS of groups S2 and S3 was significantly decreased at T1-T5 (P <0.05).There were also no signifi-cant difference in the incidence of postoperative nausea and vomiting,bradyrhythmia and hypersomnia among three groups.Conclusion Dexmedetomidine of 1.5 μg/kg can significantly reduce the dosage of sufentanil on postoperative analgesia in patients undergoing spine surgery,and decrease the rate of postoperative nausea and vomiting without any bradyrhythmia and hypersomnia.

OBJECTIVETo observe the clinical effect of Chinese medical (CM) syndrome differentiation based Chinese herbs and recombinant human tumor necrosis factor receptor II-antibody fusion protein (etanercept) for treating ankylosing spondylitis (AS) patients.

METHODSTotally 35 AS patients were treated with syndrome differentiation based Chinese herbs and etanercept. Reinforcing Shen and strengthening Du channel, activating meridians to stop pain was principle used in syndrome differentiation based treatment. Etanercept was subcutaneously injected, 25 mg each time; twice per week for the first three months and once a week for the latter three months. The clinical efficacy was evaluated after 3 and 6 months of treatment. Meanwhile, ASAS20 and ASAS50 standards arriving rates were also observed. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), visual analog score (VAS) for spine pain, VAS for night pain, patient global assessment (PGA), VAS for physician global assessment, CM syndrome score, finger-ground distance, thoracic activity, tragus-wall distance, lumbar scoliosis, cervical rotation, Schober improved test, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were observed before treatment, 3 and 6 months after treatment.

RESULTSCompared with before treatment, BASDAI, BASFI, VAS for spine pain, night pain, physician global assessment, PGA, CM syndrome score, finger-ground distance, thoracic activity, tragus-wall distance, lumbar scoliosis, Schober improved test, ESR, and CRP all decreased after 3 and 6 months of treatment, with statistical difference (P < 0.05). Cervical rotation also decreased after 6 months of treatment, with statistical difference (P < 0.05). Compared with 3 months of treatment, total effective rate of CM syndrome, ASAS20 and ASAS50 standards arriving rates increased after 6 months of treatment, with statistical difference (P < 0.05). There were statistical differences in all indices mentioned above between after 3 months of treatment and after 6 months of treatment (P < 0.05).

CONCLUSIONSyndrome differentiation based Chinese herbs combined etanercept could alleviate inflammatory reaction favorably, control the progression of active AS, and improve joint functions.

Disease Progression ; Drugs, Chinese Herbal ; therapeutic use ; Etanercept ; therapeutic use ; Humans ; Pain ; prevention & control ; Pain Management ; Spondylitis, Ankylosing ; drug therapy ; Treatment Outcome

Objective To investigate the positive detectable rate of post-traumatic stress disorder ( PTSD ) and its influencing factors among the military rescuers , and explore preventive measures for rescuers .Method At three points , 2600 soldiers from Wenchuan military rescuers were enrolled , whose PTSD symptoms were evaluated by PCL-S.Self-edited questionnaires on the general state , Alerting Test Questionnaires for Military Group Stress ( ATQMGS ) , and State-Trait Anxiety Inventory(STAI)were used to evaluate the influencing factors of rescuers′PTSD symptoms.Results Seventy-one rescuers were tested positive for PTSD and the positive detectable rate was 2.9%.On the basis of demographic data , the difference test suggested that rescuers different in terms of positions , duration of rescue, family structure, trauma history, mental problem history or trauma history during the rescue were significantly differenct in PTSD symptoms , which were strongly and positively correlated with anxiety , morale, and self-efficacy, but were strongly and negatively correlated with leadership support , control feeling , promotion motivation , cognition of tasks , sense of belonging and work value .Multiple linear regression showed that the influencing factors of PTSD symptoms included the trait of anxiety , leadership support , trauma history, control feeling, mental problem history, trauma history during the rescue, position and duration of rescue. Conclusion The PTSD positive detectable rates among the military rescuers are lower than in the previous research.PTSD symptoms of military rescuers are related to such factors as the position , duration of rescue , family structure , trauma histo ry, mental problem history, trauma history during the rescue, trait of anxiety, morale, self -efficacy, leadership support, control feeling , promotion motivation , cognition of tasks , sense of belonging and work value .The influencing factors of PTSD symptoms are the trait of anxiety , leadership support, trauma history, control feeling, mental problem history, trau-ma history during the rescue , position level and rescue duration .

The animal models used in the experimental research of Traditional Chinese Medicine (TCM) to prevent and treat T2DM are mainly spontaneous and induced. The experimental research of TCM in the prevention and treatment of type 2 diabetes can be divided into Chinese medicine compound, Chinese medicine and its extract, Chinese medicine monomer. The mechanism is mainly through regulating intestinal flora, increasing insulin content, lowering blood sugar, lowering blood lipids, improving glucose tolerance, and improving gluconeogenesis, antioxidant, inhibit cell apoptosis, etc. play the role of preventing and treating T2DM in multiple links and multiple targets.

AIM: To observe the effect of Xiaoyu Huatan Decoction on the nonalchoholic fatty liver tissue peroxisome preliferator-activated receptor?(PPAR?) expression. METHODS: The nonalchoholic fatty liver disease rat model was fed by high fat forage and the rats were divided into five groups: normal control group,model control group,high-dose of Xiaoyu Huatan Decoction group,low-dose of Xiaoyu Huatan Decoction group,Dongbao Gantai control group.Total RNA of liver was extracted,and the expression of PPAR?mRNA was analyzed by semi-quantitative RT-PCR method.We determined the contents of total cholesterol(TC),triglyceride(TG),free ratty acid(FFA) in serum and the TC,TG in liver tissue homogenate of each group,and the degree of hepatocytic steatosis. RESULTS: Expression of liver tissue PPAR? mRNA in the model group decreased significantly,lipid in blood serum and hepatic tissues increased significantly,liver fat cell greatly denaturalized.After the intervention of medicine,expression of liver tissue PPAR? mRNA of each treatment group increased significantly,lipid in blood serum and hepatic tissues decreased significantly,liver fat cell denaturation was improved. CONCLUSION: Xiaoyu Huatan Decoction can increase the expression of liver tissue PPAR?mRNA of rats,It is likely to be one of the important mechanism for treating fatty liver.