Objective: To analyze the influencing factors in thrombin titration for the determination of anticoagulant activity of Whitmania Pigra Whitman. Methods: The white porcelain plates were used as the titration carriers instead of tubes in the titration ( called white porcelain method for short) . The effect of different carriers, interval time of titration and thrombin concentration on the results of anticoagulant activity test was studied. Results:Under the same conditions, the anticoagulant activity was more accurate and stable using white porcelain method. Using white porcelain method with 20 u·ml-1 or 10 u·ml-1 as the thrombin concentration and titrating 5μl each time, once every minute, the thrombin consumption volume was linear with the sample concentration within the range of 0. 125-0. 333 g·ml-1(r20 =0. 961 and r10 =0. 992), and the anticoagulant activity respectively was (33. 08 ± 2. 64) and (31. 24 ±1.32) u·g-1(RSD20 =8.0% and RSD10 =4.2%). As for a certain sample concentration (0.333 g·ml-1), the theoretical error of determination was not more than 10% and 5%. Conclusion:The improved white porcelain method is more suitable for determining anticoagulant activity of Whitmania Pigra Whitman with more stable results and accurate end point states than tube method. Under the conditions of 10 u·ml-1 thrombin concentration, titrating 5μl each time, once every minute, the linearity, accuracy and precision are all promising.

Objective To elucidate the airway inflammation status in mice infected with respiratory syncytial virus (RSV), and whether the inflammation could be alleviated by small interference RNA (siRNA) targeting specific RSV gene. MethodsBALB/c mice were infected with RSV via intranasal instillation of RSV suspension, and were then treated with specific siRNA targeting RSV-M2 gene. ELISA assay was used to detect the levels of IFN-γ, IL-12 and IL-10 and Microscope was used to count white blood cells in bronchoalveolar lavage fluid(BALF). ResultsAfter RSV infection, a significant increase in leukocytes count was observed in BALF. Differential count showed a rise in the percentage of neutrophils, eosinophil, especially lymphocytes and a reduction of the percentage of monocytes and macrophages( P＜0.05 ).The levels of IFN-γ, IL-12 and IL-10 were also increased(P＜0.05). Furthermore, the leukocytes count,the percentage of lymphocytes, neutrophils and eosinophil, and the levels of IFN-γ, IL-12 and IL-10in BALF were decreased accordingly while the mice were given higher concentrations of siRNA ( P＜0.05 ).Conclusion RSV caused airway inflammation in BALB/c mice, which may be alleviated by RNAi technology.

Objective To explore the impact of nursing intervention on quality of life of blood dialysis patients.Methods 60 cases of hemodialysis patients were selected and divided into the experimental group and the control group with 30 patients in each group.The control group was given conventional nursing,while the experimental group was given systematic health education and psychological nursing.The differences in life quality before and after the intervention in the experimental group was evaluated with self-designed questionnaire.The changes in motor function,psychological function,social function,and material life were compared before and after the intervention between two groups.Results After the intervention,the score of motor function,psychological function and total evaluation of the experimental group were higher than those of the control group.Conclusions Nursing intervention can effectively alleviate the discomfort feeling of patients,reduce their mental pressure,increase their quality of life.Nursing intervention is closely related with quality of life.

Objective To explore the mechanism of immunomodulatory activity of triptolide on healthy volunteers peripheral blood mononuclear cells (PBMC)-derived plasmacytoid dendritic cells (pDCs). Methods Healthy volunteers-derived pDCs were sorted by flow cytometry, then incubated with triptolide (0, 5, 10, 30 μg/L). After 24 hours, we detected the concentration of IFN-α, IL-6, TNF-α using ELISA. After 5 days, the cultrural cells were collected and analyzed by flow cytometry, light microscope and electron microscope scanning. Results Triptolide-treated pDCs secreted lower level of IFN-α,IL-6 ,TNF-α, triptolide could inhibit pDCs differentiation to DCs which displayed more immature morphology and immunophenotypes than untreated-pDCs. Conclusion Triptolide could decrease the immune function of pDCs, inhibit differentiation and maturation of pDCs.

Objective:To construct a hypoglycemia nursing information system and explore its application effects in the nursing quality management of the Department of Endocrinology.Methods:Based on the existing blood glucose information management system of Peking University First Hospital, a hypoglycemic nursing information system with evaluation, alarm, record, remind, and management functions was designed. We compared the number of cases of standardized correction of hypoglycemia in inpatients by nurses, the complete and accurate cases of hypoglycemia records, and the monthly time spent on the quality control by nursing special managers before the application of the system (from February to December 2017) and after the application (from January 2018 to December 2019) .Results:After the application of the hypoglycemia nursing information system, the complete and accurate cases of hypoglycemia records, and the cases of standardized correction of hypoglycemia were statistically different from those before the application of the system ( P<0.001) . The quality control time of nursing special managers decreased from (7.55±1.01) hours a month to (0.41±0.21) hours a month. Conclusions:Application of the hypoglycemia nursing information system adapts to the hospital's management requirements for hypoglycemia, which not only promotes the standardization of nurses' handling of hypoglycemia events, improves the completeness and accuracy of written records, but also saves time for managers to perform the quality control and promotes the scientific and digitalization of nursing special management.

Objectives To evaluate the effects of "disease-characteristics nursing quality improvement" program(DNQIP)combined with targeted monitoring in reducing the incidence of ventilator associated pneumonia (VAP)among patients with mechanical ventilation and to provide evidence for the prevention of VAP. Methods This was a prospective intervention study. All mechanical ventilation patients admitted in stroke intensive care unit(SICU)of our hospital from 2007 to 2015 were selected as the research object. Targeted monitoring was implemented in patients admitted from 2007 to 2011,and DNQIP was formed based on the monitoring results. DNQIP combined with targeted monitoring was implemented from 2012 to 2013 as the first phase,and the second phase was from 2014 to 2015.Results From 2007 to 2015,the number of new patients per year and the total time of using breathing machine in SICU presented a tendency of increasing while the number of patients with VAP and the incidence of VAP presented a tendency of decreasing year by year. The implementation of DNQIP in the first phase from 2012 to 2013(incidence of VAP was 5.4 ‰),compared with the data before implementation from 2007 to 2011(incidence of VAP was 13.8‰),the incidence of VAP was significantly reduced(χ2=9.029,P=0.003). The incidence of VAP(5.3‰)in the second phase from 2014 to 2015,was significantly reduced compared with the incidence of VAP(13.8‰)from 2007 to 2011(χ2=9.559, P=0.002).Conclusions The implementation of targeted monitoring is helpful in finding problems existing in the prevention of VAP. DNQIP in patients with mechanical ventilation can effectively reduce the incidence of VAP and can refine professional assessment and health education. It is also good for the standardization and evidence-based care in the whole process provided for patients. DNQIP combined with targeted monitoring can realize the continuous quality improvement on the basis of evidence-based theory.

Objective To replicate the polymorphisms in risk genes of chronic rhinosinusitis in a Chinese Han population.Methods Enrolled in this study were CRS patients with nasal polyps (n =306,CRSwNP),CRS patients without nasal polyps (n =332,CRSsNP),and controls (n =315) in a Chinese population.All the patients were recruited from clinic of the department of Otorhinolaryngology of Beijing Tongren Hospital between 2008 February and 2009 July.A total of 10 single nucleotide polymorphisms (SNPs) selected from previous identified SNPs associated with CRS in Canadian population were individually genotyped.Allele and genotype frequencies were calculated by frequency counting,the chi-square test or exact method were applied to analyze the results.Final results were corrected by Bonferroni multiple correction.SPSS 13.0 software was used for statistical analysis.Results One SNP in AOAH gene (rs4504543,P =1.95 × 10-5,OR =0.559 0) was identified to be significantly associated with whole CRS cohort.After subgroup analysis for the presence of nasal polyps (CRSwNP and CRSsNP),the same SNP in AOAH (rs4504543,P =3.47 × 10-12,OR =0.284 8) was also found to be significantly associated with CRSsNP cohorts.Conclusions AOAH was significantly associated with CRS and its polymorphisms might play a role in the susceptibility to develop CRS in Chinese population.

Objective To explore the effects of the training the trainers model in the quality control circle training.Methods According to the training the trainers model, 27 nurses were involved as trainers and received quality control circle training by 6 mentors from 2013 to 2015. The training capacity of trainers and the training effect of the target group were assessed before and after training. The lasting effect after training were evaluated.Results The self-assessment score of 6 trainers′ training capacity after training (4.30±0.54) was significantly higher than before training (1.41±0.50) (t=-19.98, P<0.01). The self-assessment score of 189 circle members′ training capacity after training ( 27. 51 ± 4. 19 ) was significantly higher than before training (20.52±4.56) (t=-18.722, P<0.01). The percentage of nursing staff participating in the quality control circle significantly increased from 2.8% to 12.4% after the whole process (χ2=226.378, P<0.01).Conclusions The training the trainers model is effective in improving training capacity of trainers in quality control circle training and increasing effects of quality control circle training among target nurses and is an effective model in training quality control circle on nurses.

ObjectiveTo systematically review the available studies about Guanxinjing capsules in treating angina pectoris of coronary heart disease （syndrome of Qi deficiency and blood stasis）， evaluate the evidence quality and comprehensive value of Guanxinjing capsules in 6+1 dimensions involving 9 aspects， and clarify the clinical positioning and advantages of this medicine. MethodsA qualitative combined with quantitative evaluation method was adopted， involving clinical medicine， epidemiology， evidence-based medicine， and pharmacoeconomics. Through public data collection， questionnaire surveys， real-world data collection， and literature comprehensive evaluation， an evaluation system involving 9 aspects in 6+1 dimensions was constructed for Guanxinjing capsules. Experts assigned weights to the criterion layer and indicator layer， and the multi-criteria decision analysis （MCDA） model and CSC （V2.0） were employed to measure each dimension and reveal the clinical value of Guanxinjing capsules. Results①The evaluation results showed that Guanxinjing capsules are safe. According to the adverse reactions in the instructions， the systematic evaluation and meta-analysis of clinical safety， and the data collected by the National Center for Adverse Drug Reaction Monitoring， the adverse reactions of Guanxinjing capsules mainly include chest tightness， dyspnea， dizziness， and digestive system-related symptoms， with a standardized score of 0.75 points， which suggests good safety. ②The meta-analysis results suggest that according to the same efficacy standards， the effectiveness of Guanxinjing capsules alone and Guanxinjing capsules combined with conventional Western medicine or Chinese patent medicines is higher than that of conventional Western medicine or the Chinese patent medicine Shenshao capsules alone in treating coronary heart disease. The standardized score of effectiveness is 0.57， which indicates that the effectiveness still requires evidence support. ③With the individual disposable income in 2020 as the expected payment assumption threshold， compared with conventional treatment alone， combining Guanxinjing capsules with conventional treatment is cost-effective and economical for the patients with angina pectoris of coronary heart disease under certain conditions （higher than 106.91 yuan）， which suggests good economy. ④At present， 3 patents for the invention of Guanxinjing capsules have been approved， covering multiple fields such as clinical innovation， service system innovation， and industrial development， which implies good innovation. ⑤In addition， the questionnaire surveys for medical staff involve five different dimensions， and the statistical scores and evaluation results show good suitability of Guanxinjing capsules. ⑥The reimbursement rate of Guanxinjing capsules by residents is high. The sampling survey results show that Guanxinjing capsules are fully equipped in hospitals across China and have good accessibility. ⑦Derived from the theory of activating blood and resolving stasis proposed by Wang Qingren， a famous physician in the Qing Dynasty， Guanxinjing capsules integrate multiple therapies such as replenishing Qi， nourishing Yin， and aromatic warming and unblocking. According to the analysis data in the "6+1" dimensions， the clinical comprehensive evaluation score of Guanxinjing capsules for angina pectoris of coronary heart disease （syndrome of Qi deficiency and blood stasis） was 0.73. ConclusionThe results of comprehensive evaluation of each dimension and clinical value suggest that Guanxinjing capsules in treating angina pectoris of coronary heart disease （syndrome of Qi deficiency and blood stasis） have sufficient clinical evidence， good safety， suitability， and accessibility. It is recommended that Guanxinjing capsules can be included in the documents of basic clinical medication management in accordance with the established procedure.

ObjectiveTo systematically review the studies about Yiqing Capsules in the treatment of pharyngitis， tonsillitis， gingivitis， and oral ulcers with heat-toxin syndrome and clarify the advantages and therapeutic characteristics of Yiqing capsules， thus providing reference for the decision-making by relevant departments and clues for the clinical and basic research. MethodThe multi-criteria decision analysis （MCDA） model and CSC v2.0 were employed to comprehensively evaluate Yiqing capsules from multiple aspects. ResultThe serious adverse reactions in the spontaneous reporting system （SRS） monitoring data of Yiqing capsules included pruritus， rash， an ddiarrhea， all of which were relieved or cured， without aggravation or interhospital transfer for treatment. Literature data showed that the main clinical adverse reactions were abdominal pain， diarrhea， etc. Both acute toxicity and long-term toxicity tests showed good safety， and thus the safety of Yiqing capsules was rated as grade B. The results of Meta-analysis showed that Yiqing capsules used alone or in combination with other medicines outperformed Niuhuang Jiedu capsules or Western medicine in the treatment of pharyngitis， tonsillitis， gingivitis， and oral ulcers with heat toxin in terms of symptom alleviation， disappearance rate of main symptoms， and recurrence rate of aphtha. Pharmacological and pharmacodynamic studies showed that Yiqing capsules had antimicrobial， antiviral， and anti-inflammatory effects， with the effectiveness rated as grade B. The decision tree model was adopted to analyze the incremental cost-effectiveness ratio. With the threshold of 1 fold per capita GDP and the disappearing rate of pain in gingivitis as the indicator， Yiqing capsules had an economic advantage in the treatment of gingivitis due to heat-toxin compared with Niuhuang Jiedu capsules， and the incremental cost-effectiveness ratio was 0.39 yuan/%， which indicated acceptable cost， with the economy rated as grade B. Yiqing capsules can not only clear heat from Qi aspect but also purge blood fire， serving as the representative prescription of clearing and purging for heat-toxin syndrome. Considering the industrial service system and enterprise innovation， the comprehensive innovation of Yiqing capsules was rated as grade B. Generally， this product does not require personalized treatment plans and features convenient supply， storage， transportation， policy publicity， drug information standards， and easy operation for medical care and patients. The Chinese patent medicine information was complete and in line with national standards， and thus the suitability of Yiqing capsules was rated as grade A. With a low price and good availability and affordability， the accessibility of Yiqing capsules was rated as grade A. The Yiqing capsules prescription， Sanhuang Xiexin decoction， originated from ancient medical books， with rich real-world studies， and thus the traditional Chinese medicine characteristics of Yiqing capsules was rated as grade C. ConclusionThe clinical value of Yiqing capsules was rated as grade B from the "6+1" dimensions， suggesting that it could be conditionally converted into the relevant policy results of basic clinical drug management according to the procedure.