Objective With a network meta-analysis,to compare the effects and safety of seven clinically common-used induction methods.Methods Publications of randomized controlled trials between January 1,1980 and November 20,2011 were searched on Medline,Embase and Cochrane Central Register of Controlled Trials with the following terms including dinoprostone,misoprostol,Foley catheter,oxytocin and labor induction.A network meta analysis with both direct and indirect comparison was applied for 48 randomized controlled trials (19 819 participants) recruited,and the following seven induction methods applied in the publications were compared:oxytocin (intravenous,Ⅳ),vaginal dinoprostone,intracervical dinoprostone,oral misoprostol,vaginal misoprostol,sublingual misoprostol and foley catheter.The main outcomes were the proportion of vaginal delivery within 24 hours,cesarean section rate,uterine hyperstimulation rate and Apgar score＜7 at 5 min after birth.Medline,Embase and Cochrane Central Register of Controlled Trials were searched between January 1,1980 and November 20,2011.Results Foley catheter methods had the lowest cesarean section rate and the lowest uterine hyperstimulation rate.Vaginal misoprostol method had the highest number of vaginal delivery within 24 hours,but the highest uterine hyperstimulation rate.The lowest rate of neonatal Apgar score＜7 at 5 min was found in women using sublingual misoprostol,while the highest in those using vaginal Dinoprostone.Oxytocin (Ⅳ) method had the lowest number of vaginal delivery within 24 hours and the highest cesarean section rate.Conclusion Foley catheter method is the best available option for labor induction in terms of efficacy and safety,while the induction effect of oxytocin (Ⅳ) was not good enough.Vaginal misoprostol and vaginal dinoprostone methods had relative good induction effect but with obvious adverse effects.

Objective To establish a short-term scenario simulation training campus in senior med-ical students before graduation for the sake of a smooth transformation from medical students to residents. Methods There were 101 participants involved in the study . All the participants attended emergency medicine traditional teaching, including 51 fourth-year medical students and 50 fifth-year medical students. The 48 students who took the emergency scenario simulation training course were classified as training camp group while the other 53 students were classified as control group. The control group only participated in the emergency medicine traditional teaching, and the training camp group participated in the emergency sce-nario simulation training course on the basis of control group's routine teaching, including advanced cardiac life support and team collaboration, sepsis and doctor-patient communication, polypnea and crisis manage-ment, disorder of consciousness and interdisciplinary teamwork, multiple injuries and emergency plans, and comprehensive case evaluation. The training camp group was divided into groups and received evaluation of performance on treating emergency simulated case (clinical skills, teamwork, doctor-patient communication) before and after class. The training camp group was received questionnaire survey after class. SAS 9.2 was used to do the t test and descriptive analysis. Results There were no statistically significant differences (P>0.05) between the scores of the performance on clinical skills, teamwork, doctor-patient communication of training camp group and control group before class. The scores of training camp group after class were sig-nificantly better than those of control group (P<0.05). In addition, the course had a high recognition by students. 92% (44/48) students thought the course was contributed to improving the ability of crisis man-agement and clinical practice and were in favor of developing similar courses for senior medical students. Conclusion Scenario simulation training campus can strengthen the cultivation of medical students' com-prehensive thinking, independent clinical decision making, practice skills and communication ability in the final stage of medical education as well as enhancing their self-confidence so as to help them to adapt to the real clinical work.

Objective To investigate APP mobile information technology innovation methods in preoperative visits to patients in the clinical application effect. Methods A total of 840 patients undergoing elective surgery were divided into control group and experimental group by random digits table method with 420 cases each and control group by adopting the method of the nurse oral interpretation of the preoperative visit list and health education leaflets oral interpretation information, experimental group using mobile medical technology innovation preoperative visit method, combining with specialized subject characteristic in APP software design way of cartoon animation and video surgery in patients with preoperative visit. The comparison of two groups of patients with the patients know about the operation, cooperate with surgery, perioperative anxiety levels, hospitalized experience satisfaction four dimensions of experience were performed. Results The patients know about the operation was (7.6 ± 2.3) points in control group and(8.5 ± 2.5)points in experimental group, and there was significant difference between two groups (t=5.430,P<0.01). The cooperate with surgery was 92.62%(389/420) in experimental group and 75.71%(318/420) in control group, and there was significant difference between two groups(χ2=45.032, P<0.01). The perioperative anxiety levels was (38.27 ± 2.50) points in experimental group and (47.21 ± 3.84) points in control group, and there was significant difference between two groups (t=8.420, P<0.01). The hospitalized experience satisfaction was (96.41±2.30) points in experimental group and (93.70±1.51)points in control group, and there was significant difference between two groups (t=3.297, P <0.01). Conclusions Using APP for clinical preoperative visit mobile information technology, which can effectively improve the patients know about the operation and the matching degree, reduce the perioperative patients with anxiety, improve surgical patients during hospitalization medical treatment satisfaction.

Objective To observe the results of treatment by open reduction and humeral head replacement for proximal humeral fracture-dislocation. Methods According to Neers classification, the cases included two-part proximal humeral fracture-dislocation 15 cases, three-part proximal humeral fracture-dislocation 29 cases, and four-part proximal humeral fracture-dislocation 21 cases. Fifty-four patients received T shaped steel plate and 11 patients received humeral head replacement. Early rehabilitation was started postoperatively. Results Fifty-four patients who received T shaped steel plate were followed up from 1 to 5 years (in average of 2.5 years), final results of all the patients were evaluated according to the HUANG Gong-yi′s criterion. The rate of excellent or good in patients of two-part fracture-dislocation were 100%, three-part fracture-dislocation was 79%, humeral head necrosis was 25%, four-part fracture-dislocation was 60%, and humeral head necrosis was 53%. Eleven patients who received humeral head replacement were followed up from 6 months to 5 years (in average of 1.5 years). According to SSMH of UCLA, the average score was 25.6. Score was above 27 in 1 case, 24~27 in 8 cases, 18~ 23 in 2 cases, less than 18 in 0. These cases were with an excellence rate of 82%. Average score was 9.0 in pain, 8.2 in function and 7.5 in muscle power. Conclusions T shaped steel plate to treat the two-part proximal humeral fracture-dislocation is effective in the functional recovery of the shoulder joint, but the rate of satisfaction as well as the necrosis in the three-part and four-part is poor. Satisfactory results can be obtained in humeral head replacement for the treatment of proximal humeral fractures especially for the treatment of three and four-part fracture-dislocation.

Objective To detect the expression levels of miR-7-5p and POLE4 in non-small cell lung cancer cells and their effect on cells proliferation, migration and invasion. Methods qRT-PCR was used to detect the relative expression levels of miR-7-5p and POLE4 mRNA in NSCLC tissues, adjacent tissues, tumor cells and human normal bronchial epithelial cells. Luciferase reporter gene was used for analyzing of the targeting relation between POLE4 and miR-7-5p in NSCLC cells. si-NC and si-POLE4 were transfected into SPC-A-1 cells as the si-NC group and si-POLE4 group, and the control group was set at the same time. MTT method, scratch test and Transwell test were used to detect cell proliferation, migration and invasion. Results The expression levels of miR-7-5p in NSCLC tissues and cells were reduced, and the expression levels of POLE4 were increased. miR-7-5p could target to combine with POLE4. After 72 hours of culture, the OD value in si-POLE4 group was significantly lower than those in the control group and si-NC group (P < 0.05). The migration rate and the number of transmembrane cells in the si-POLE4 group cultured for 48 hours were lower than those in the control group and the si-NC group (P < 0.05). Conclusion miR-7-5p may inhibit the proliferation, migration and invasion of non-small cell lung cancer cells by targeting POLE4.

Objective To summarize the key points of cooperative nursing care to patients with pelvic, acetabular and peripheral tumors treated with half pelvic prosthesis replacement with computer aided 3D printing. Methods Night patients with pelvic, acetabular and peripheral tumors treated with half pelvic prosthesis replacement with computer aided 3D printing during April 2014 and March 2017 were included in the study. Before replacement, the entity models were printed for confirmation of tumor range, surgical simulation and planning. After resection of tumors, the half pelvic prosthesis by 3D printing was used to reconstruct the bone defects. The points for nursing cooperation were summarized. Result All the patients lived through the replacement and survived by short-term follow-ups, reporting no complications and normal function of hip joint at movement. Conclusion In view of nursing the patients with with pelvic, acetabular and peripheral tumors treated with half pelvic prosthesis replacement with computer aided 3D printing, such nursing measures as careful preoperative preparation for the surgery, specialized nursing assessment, body position nursing, aseptic operation and tumor free technique, dynamic observation of vital signs and close nursing cooperation are critical for the success of half pelvic prosthesis replacement.

Objective:To compare the consistency and detection capability of seven 2019-nCoV nucleic acid detection kits, and provide reference for detection method selection of clinical laboratory and diagnosis of new coronavirus pneumonia.Methods:Two batches of pharyngeal swab samples were collected from tenpatients with confirmed infection of 2019-nCoV and 10 suspected patients with negative 2019-nCoV test results during January 29 to February 5, 2020 in Shenzhen Luohu People′s Hospital. Seven kinds of kits were labeled as ato g and used for nucleic acid detection respectively to evaluate the consistency of the test results of the clinical samples. A 2019-nCoV positive specimen was selected and diluted to 5-concentration gradient plates (Level-1 to 5) with RNase-free water. The positive detection rate and intra-batch repeatability of different brands of kits were compared.Results:The negative and positive coincidence rates of twenty clinical samples tested by six kinds of kits were 100%, and the positive and negative coincidence rate was 8/10 and 10/10 for the other kit, respectively. The results of intra-batch repeatability showed the CVs of viral loads tested by these seven kits were all less than 5%. In the concentration range of Level-1 to 3, the detection capability for open reading frame (ORF)1ab gene of Kit b,d and f was lower than Kit a,c,e and g, and the detection capability of kit e and g was the highest (14/15). The detection capability for N gene of Kit a (15/15) was higher than the other 5 kits. The comprehensive analysis of the detection capability for ORF1ab and N gene showedthat Kit d had the lowest detection capability (ORF1ab:40%,N:53%), and there was no significant difference in the detection capability of Kit a, b, c, e, and f.Conclusions:There was no significant difference in the accuracy and repeatability of the seven kits for positive samples with high viral loads, and the detection performance was good; but some kits had poor detection capability for weak positive samples. It is suggested that the weak positive samples should be rechecked by at least two manufacturers′ kits to ensure the accuracy of the results.

Objective To explore the effective measures for the stability of micro-environmental indicators in clean operating department.Methods Professionals of clean technology were invited to participate in unit operation and maintenance of management.Besides, operating room managers conducted regular sampling analysis of five micro-environmental indicators, including temperature, humidity, differential pressure, illumination and decibel, in 100-level, 1 000-level, 10 000-level, 100 000-level clean operating rooms, and compared the test results with parameters of target environmental indicators regulated in national standards.Then the test results of annual bacteria subsidence from different operating rooms in clean operating department were compared.Results Under the management of professionals, the values of temperature, humidity, differential pressure, illumination and decibel from micro-environment in 100-level, 1 000-level, 10 000-level, 100 000-level clean operating rooms were in accordance with rated values in the industry with ( P>0.05);the annual bacteria subsidence in 100-level, 1 000-level, 10 000-level, 100 000-level clean operating rooms in 2013 was in accordance with the standards specified in GB50333 and clearly less than rated values.Conclusions Professional participating in the management and maintenance of micro-environment in clean operating department and irregular supervision and sampling test by operating room managers, the micro-environmental indicators in operation department can be well controlled.

Objective? To determine tourniquet pressure based on limb occlusion pressure(LOP) and to explore its effects on laparoscopic surgery in adults. Methods? Totally 200 adult patients who received laparoscopic surgery in a Class Ⅲ Grade A hospital between June and December 2017 were selected by cluster sampling and divided into the control group (n=100) and the observation group (n=100) according to the random number table. The conventional pressure of 450 mmHg (60 kPa) for lower exterminates was applied to the patients in the control group, while the pressure for the patients in the observation group was determined on limb occlusion pressure with the arterial pulse probe in air pressure tourniquet in accordance with the guideline of the Association of Perioperative Registered Nurses (AORN, 2013) and the care guideline for surgical patients using air pressure tourniquet. The surgical vision score, air pressure tourniquet pressure, color of skin at tourniquet cuff and change of skin morphology were observed and recorded. Results? The clearance of surgical vision of the two groups was 86% and 82%, respectively (P＞ 0.05). The pressure of air pressure tourniquet of the observation group was (316.48±20.10) mmHg, while the fixed pressure of the control group was 450 mmHg (P＜0.05). The incidence of cutaneous injury comorbidities in the control group was 65%, while the incidence of postoperative skin injury in the observation group was 20% (P＜ 0.05). Conclusions? The tourniquet pressure determined based on limb occlusion pressure in laparoscopic surgery for adult patients does not affect the vision of surgeons and can effectively reduce the adverse effects of tourniquet used during operation.

OBJECTIVE To evaluate the effect of manipulation of Imipenem and cisplatin sodium （ICS） for injection on the consistency of its main drug imipenem （IPN） content， and the stability of different concentrations of ICS solution， to provide a reference for the safe and effective use of ICS in children. METHODS Three operators prepared ICS solutions according to the two commonly used dosage methods for children （10 mL or 20 mL 0.9% Sodium chloride injection to prepare the initial ICS solution and draw the required dose from the initial suspension）. The content of IPN was determined by ultra-high performance liquid chromatography-tandem mass spectrometry after parallel processing. The content consistency of solutions in each group was determined according to the coefficient of variation （CV）＜15% of the IPN content. ICS test solution X1 was prepared according to the instructions， and then test solutions X2 and X3 were prepared by diluting X1 with 0.9% Sodium chloride injection in the volume ratios of 1∶1 and 1∶2， which were stored at room temperature （[ 23.0±0.5） ℃]， in a thermostatic water bath at 30 ℃， and in a refrigerator at 2-8 ℃. The stability of the drug solution was determined by the ratio of the IPN mass concentration measured at the specified temperature and time to the initial （0 h） mass concentration （if the ratio was≥90%， it was considered that the drug solution was stable）. RESULTS CV of IPN content was ＜15% in each group of solutions prepared with two manipulation methods by each operator， indicating a small deviation in IPN content. The solutions at the three concentration levels were stable at room temperature for 6 h or refrigerated for 18 h. The test solutions X1 and X2 were also stable when placed at 30 ℃ for 6 h， but the IPN concentration in test solution X3 decreased by about 20% compared with that of 0 h. CONCLUSIONS The consistency of the content of IPN is good in the two commonly used methods for ICS manipulation in children. The stability of ICS solution is affected by concentration， temperature and time. Lower concentrations at higher temperatures resulted in decreased stability of IPN. Clinical attention should be paid to controlling the amount of solvent as well as temperature and time during preparation and use.