A gap is found between the existing quality of care,and social expectations and the PDCA model.Peking University People's Hospital applied the quality control circle in building a supervision platform for medical quality and sustained improvement of civilized services.This study demonstrated the efforts in this regard made by the hospital,and the major outcomes of the platform in its 6-year practice in identifying service defects,optimizing service processes and sustained improvement of medical services.In addition,it also shared insights on enhanced real-time supervision,standardized management,and long-term mechanisms of the hospital.

Objective To discuss the diagnosis and treatment of splenic harmatoma(SH). Methods The clincial data of three cases of SH treated in our hospital from January 1997 to December 2007 were collected,and the other 17 cases which were published from January 1997 to December 2007 in the Chinese biological and medical lit-erature database were reviewed. The clinical manifestation,pathological findings,diagnosis and treatment of these 20 patients were analyzed. Results The main symptoms were abdominal pain or discomfort and abdominal mass in 13 cases(13/20). All 20 patients underwent surgical treatment with good recovery without severe complications and re-currence. Conclusions The definite diagnosis of SH depends on postoperative pathological findings. Complete surgi-cal resection is the best treatment for SH with favourable prognosis.

Animals ; Astragalus Plant ; Cardiomyopathies ; Myocardial Ischemia ; Myocardium ; Rats

OBJECTIVETo assess the efficacy and safety of recombinant human thrombopoietin (rhTPO) on chemotherapy-induced thrombocytopenia in patients with solid tumor.

METHODSIn this randomized crossover self-controlled multi-center clinical trial, 154 patients with solid tumor were randomly divided into two groups (group A 77 cases and group B 77 cases). All patients were given the same two cycles of chemotherapy. In group A, the first cycle was treated cycle, in which patients were given rhTPO, while the second cycle was non-treated cycle as a control. In group B, the first cycle was non-treated cycle as a control, while the second cycle was treated cycle. RhTPO 1.0 microg/(kg x d) was administered subcutaneously 6-24 hours after chemotherapy for the longest 14 days. Laboratory tests included complete blood counts, urinalysis, serum chemistry, coagulant test, chest radiography, and electrocardiogram. Serum samples were screened for anti-rhTPO antibodies.

RESULTSIn both group A and group B, platelet decrease and duration had no significant difference between the treated cycle and non-treated cycle. Platelet count was higher in the treated cycle, than in the non-treated cycle: [minimal mean platelet count (64.4 +/- 45.4) x 10(9) cells/L and (52.4 +/- 30.9) x 10(9) cells/L (P=0.000), maximal mean platelet count (263.9 +/- 142.5) x 10(9) cells/L and (148.9 +/- 67.7) x 10(9) cells/L (P=0.000)]. Duration of thrombocytopenia was shorter in the treated cycle than in the non-treated cycle [days with platelet count < 50 x 10(9) cells/L, (2.5 +/- 3.9) and (3.7 +/- 5.7) (P=0.04); days with platelet count recovered > or = 75 x 10(9) cells/L, (10.3 +/- 8.7) and (14.0 +/- 8.9) (P=0.000), and days with platelet count recovered > or = 100 x 10(9) cells/L, (15.9 +/- 10.5) and (21.1 +/- 9.5) (P=0.000)]. The need for platelet transfusion was not significantly reduced in treated cycle. The effects of rhTPO on WBC, Hb, hepatic function, renal function, and coagulant function were not found. Transient low-titer non-neutralizing antibody was developed in one patient. Therapy with rhTPO was tolerated by all patients. Mild side effects were observed in individual patients, including fever, dizziness, and chill. Conclusion Administration of rhTPO after chemotherapy can significantly reduce the degree and duration of thrombocytopenia and promote platelet recovery. Therapy with rhTPO seems to be safe.

Adolescent ; Adult ; Aged ; Antineoplastic Agents ; adverse effects ; Cross-Over Studies ; Female ; Humans ; Lung Neoplasms ; blood ; drug therapy ; Male ; Middle Aged ; Neoplasms ; blood ; drug therapy ; Platelet Count ; Recombinant Proteins ; administration & dosage ; therapeutic use ; Thrombocytopenia ; chemically induced ; drug therapy ; prevention & control ; Thrombopoietin ; therapeutic use

OBJECTIVETo probe the approach of emergency management for severe pelvic fracture associated with injuries of adjacent viscera and evaluate the therapeutic effect.

METHODSThe data of 79 patients with severe pelvic fracture associated with injuries of adjacent viscera were retrospectively studied, and the study covered a period of 14 years.

RESULTSLigation of internal iliac arteries was performed in 33 cases for ceasing massive bleeding due to pelvic fracture, and angioembolization in 8. Of 42 patients with cystic or/and urethral injury, 35 underwent cystostomy and delayed reconstruction, and 7 received a primary realignment. All of 17 patients with injury of retroperitoneal rectum underwent diverting colostomy of the proximal end of sigmoid with presacral drainage, but 4 received primary repair without colostomy. In 22 patients with intraperitoneal colorectal injury, 19 were managed with primary repair or anastomosis while 3 received a colostomy. The overall mortality rate was 9% (7/79); The main causes were hemorrhagic shock and associated injury. The complications included urethro-rectal fistula in 4, thrombosis of right common iliac artery in 1, acute respiratory distress syndrome (ARDS) following chest trauma in 1, and paraplegia in 1. Except the patient with paraplegia, all of them were cured.

CONCLUSIONSPrompt diagnosis and proper treatment were the key of the success. Devascularization of internal iliac arteries with external fixation cage of pelvis, cystostomy and proximal sigmoidostomy were effective procedures frequently used in the emergency treatment of the severe pelvic fracture patients.

Abdominal Injuries ; diagnosis ; etiology ; surgery ; Adolescent ; Adult ; Aged ; Colostomy ; Female ; Fractures, Bone ; complications ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; Retrospective Studies ; Urinary Diversion

To construct a non-resistance and attenuated Salmonella typhimurium strain which expresses conservative region of adhesin(AB) of Helicobacter pylori(Hp). The AB gene was amplified by PCR and inserted into the expression vector pYA248 containing asd gene and was introduceded into the delta Cya, delta Crp, delta Asd attenuated Salmonella typhimurium strain by twice transformations, which is a balanced lethal recombinant. Bridged ELISA method was used to measure AB expressed in sonicate and culture supernatant. According to Meacock's way and growth curve, stability of the recombinant is evaluated. Semi-lethal capacity test was used to evaluate the safty of recombinant. Results showed S. typhimurium X4072(pYA248-AB) was constructed successfully, recombinant X4072(pYA248- AB) content of supernatant serum was higher than that of thallus lytic liquor confirmed by bridged ELISA, and after recombinant pYA248- AB cultured 100 generation without selection pressure, all the recombinant germ selected randomly can grow, and the AB antigen was positive by ELISA detection. The growth curve of the recombinant germ showed that the growth state of X4072(pYA248) and X4072(pYA248- AB) were coincidence on the whole, and the survival rate of C57BL/6 was still 100%, 30 days after taking X4072(pYA248- AB) 1.0 x 10(10)cfu. orally. Non-resistance S. typhimurium X4072(pYA248- AB) was constructed successfully. The recombinant plasmid was stable indicated by in vitro experiment. And the recombinant strain was safe confirmed by animal experiment. This live vaccine strain is worthy to be considered as a new live oral vaccine candidate against Hp infection.
Adhesins, Bacterial ; genetics ; metabolism ; Animals ; Enzyme-Linked Immunosorbent Assay ; Genetic Vectors ; genetics ; Helicobacter pylori ; genetics ; Male ; Mice ; Mice, Inbred C57BL ; Plasmids ; genetics ; Polymerase Chain Reaction ; Salmonella typhimurium ; genetics ; growth & development ; metabolism

Induced pluripotent stem (iPS) cells were originally generated from mouse fibroblasts by enforced expression of Yamanaka factors (Oct3/4, Sox2, Klf4, and c-Myc). The technique was quickly reproduced with human fibroblasts or mesenchymal stem cells. Although having been showed therapeutic potential in animal models of sickle cell anemia and Parkinson's disease, iPS cells generated by viral methods do not suit all the clinical applications. Various non-viral methods have appeared in recent years for application of iPS cells in cell transplantation therapy. These methods mainly include DNA vector-based approaches, transfection of mRNA, and transduction of reprogramming proteins. This review summarized these non-viral methods and compare the advantages, disadvantages, efficiency, and safety of these methods.
Animals ; Cellular Reprogramming ; Humans ; Induced Pluripotent Stem Cells ; physiology ; Transduction, Genetic ; Transfection ; Transgenes

OBJECTIVETo sum up causes and the prevention of complications after using the radio frequency ablation (RFA) to treat of primary and secondary liver cancers.

METHODSThe clinical courses of 735 patients, undergoing percutaneous RFA treatment for a total of 1780 times were reviewed. The causes of the complications occurring after the RFA treatment, and their prevention and treatment were evaluated.

RESULTSEleven complications after RFA treatment were found. Postoperative fever, sweating, and local pain were common. Serious complications, such as gut perforation, intraabdominal hemorrhage, and cardiovascular accident were found in 4 patients, and the mortality was 75%.

CONCLUSIONSThe RFA treatment is an effective method for the treatment of primary and secondary liver tumor. Careful selection of patients, appropriate preoperative preparations, proper operative procedures, and suitable postoperative care are the key points in preventing the complications.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; secondary ; surgery ; Catheter Ablation ; adverse effects ; Female ; Humans ; Liver Neoplasms ; secondary ; surgery ; Male ; Middle Aged

Objective To provide the evidence for the development of personalized health education courses for twin pregnant women.We explored the health education and psychosocial demand of twin pregnant women from the perspective of social ecosystem theory.Methods By purposive sampling,18 twin pregnant women hospitalized in the twin medical center of a tertiary A hospital in Shenyang from January to March 2023 to conduct for semi-structured interviews,and Colaizzi's 7-step analysis method was used to sort out and analyze the data.Results 3 themes were extracted from the health education and psychosocial needs of twin pregnant women.Microsystem:the content needs of twin pregnant women's health education(the guidance needs of nutrition intake and weight growth;the needs for fetus health monitoring guidance;the cognitive needs of twin pregnancy complications;the needs for health education knowledge related to puerperium and the diversification of the choice of teaching methods).Mesosystem:the emotional support needs of twin pregnant women during prenatal and puetperal(the needs of family support and peer education support).Macrosystem:seeking social support and network information support(the demand of community support;the needs of information related to twin pregnant women's hierarchical management system and maternal fetal medical referral process and the needs for network health education information).Conclusion The women with twin pregnancy have different needs for health education content in each stage of pregnancy and puerperium,and there are urgent needs for emotional support and social support.Clinical nurses should construct health education courses according to the needs of twin women,and innovate in content and form,so as to improve the self-care ability of twin pregnant women and the knowledge level of family caregivers,and improve the pregnancy outcome.

OBJECTIVETo compare the bidirectional effect of rhubarb total anthraquinone (TA) and total tannins (TT) on rats' liver.

METHODSOne hundred rats were randomly divided into 10 groups, i.e., the blank group, the model group, the blank + high dose TA group, the blank +low dose TA group, the blank + high dose TT group, the blank + low dose TT group, the model + high dose TA group, the model + low dose TA group, the model +high dose TT group, and the model + low dose TT group, 10 in each group. The carbon tetrachloride (CCI4) was used to prepare the acute liver injury rat model. TA and TT of rhubarb (at 5.40 g crude drugs/kg and 14.69 g crude drugs/kg) were intragastrically administrated to rats in all groups except the blank group and the model group, once daily for 6 successive days.The general state of rats, biochemical indices such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), laminin (LN), hyaluronic acid (HA), transforming growth factor beta1 (TGF-beta1), as well pathological results of rat liver tissues. Finally the protection laws of TA and TT for rats' liver were analyzed using factor analysis.

RESULTSCompared with the blank control group, all biochemical indices increased in the blank group (P < 0.05, P < 0.01). HA also increased in the blank + high dose TA group; AST, ALT, and HA also increased in the blank +high dose TT group (P < 0.05). Compared with the model group, AST, ALT, ALP, HA, and TGF-beta1 significantly decreased in the model + low dose TA group, the model + high dose TA group, the model + low dose TT group (P < 0.05, P < 0.01). Serum AST, ALT, and ALP also decreased in the model + high dose TT group (P < 0.05, P < 0.01). Pathological results showed that mild swollen liver cells in the model + high dose TA group. Fatty degeneration and fragmental necrosis around the central veins occurred in the blank + high dose TA group. The pathological injury was inproved in the model +low dose TA group. Two common factors, liver fibrosis and liver cell injury, were extracted by using factor analysis. TA showed stronger improvement of the two common factors than TT.

CONCLUSIONSRhubarb TA and TT showed protective and harmful effects on rats' liver. At an equivalent dosage, TA had better liver protection than TT. High dose TT played a role in liver injury to some extent.

Animals ; Anthraquinones ; adverse effects ; pharmacology ; Carbon Tetrachloride ; toxicity ; Chemical and Drug Induced Liver Injury ; drug therapy ; pathology ; Dose-Response Relationship, Drug ; Female ; Liver ; drug effects ; Male ; Rats ; Rats, Sprague-Dawley ; Rheum ; chemistry ; Tannins ; adverse effects ; pharmacology