Objective To standardize the operation processes of neonatal instrument,ensure the standards effectiveness and safety of equipment use.Methods A retrospective study had been taken on after the developments and implementations of all neonatal instruments standard operation procedure (SOP).The equipment maintenance data were collected and analyzed one year before and after the implementation of SOP.Results After the effective implementation of the SOP,the incidence of instrument repair due to misoperation,improper maintenance reduad by 59％(19/32),9/14,4/7,the instrument management efficiency was enhanced,and the safety of nurses and patients was guaranteed,and the patients satisfaction was improved,and also the quality of care was enhanced.Conclusions SOP procedure plays a very important role in improving neonatal care management and overall efficiency.It makes a continuous improvement of nursing care which is worth widely being implemented.

Objective To analyze MRI features of breast intraductal papilloma,to improve the acquaintance of this disease.Methods The preoperative MRI images (T2 WI-SPAIR,DWI,ADC,TIC and MIP)of eight patients with breast intraductal papilloma confirmed by surgery were reviewed retrospectively,which were compared with the postoperative pathology.The morphology,distribution, enhanced methods and signal characteristics of the lesion were summarized.Results Of 8 cases,the lession was dormant,and MRI revealed three patterns:the first type was occult papilloma,which presented distention of ducts and no solid nodule in 3 cases (37.5%);the second type showed tiny nodules in bar-like dilatation of ducts in 3 cases (37.5%);and the third type presented small round nodules scattering distribued in terminal ductules in 2 cases (25%).The maximum diameter of nodular lesions was 0.4-1.0 cm(average 0.7 cm).The lesions on T2 WI-SPAIR showed equal signal intensity or mixed signals with isointensity/hypointensity,and dilatation catheter.enhancement. The ADC and TIC value were various,therefore,diagnosis of the tumor should be combined with morphology and associated symptoms. Conclusion At early stage,the occult focus of breast intraductal papilloma can be sensitively detected and localized on MRI.It reveals that MRI has advantage in showing morphology of lesion and functional imaging,which is of important value in clinical diagnosis and early treatment.

OBJECTIVE To optimize the parameters of passive cutaneous anaphylaxis(PCA)in rats immunized by ovalbumin(OVA). METHODS 1-2 month-old Sprague-Dawley rats were immu?nized by ip injection of OVA(0.2,1.0 and 5.0 mg per rat)mixed with complete Freund′s adjuvant once every other day 3 times. Serum was collected on the 12th-16th days after final immunization. Then the rats were intracutaneously injected with sensitized serum and then stimulated by iv injection of the same dose of OVA mixed with Evans blue after a latent period of 0.5,1.5,3,6,12,24,36,48 and 60 h. Finally,the diameters of blue spots in the skin were measured at stimulation. RESULTS Serum total-IgE(T-IgE)and OVA-specific IgE(sIgE)levels increased significantly and reached the peak on the 3rd-7th days and 12th-16th days after final immunization,respectively. There was no correlation between the serum T-IgE level and OVA-sIgE level when the rats were immunized with OVA at OVA 0.2-5.0 mg per rat. The rats experienced PCA after injection of OVA 1.0 and 5.0 mg per rat. Diameters of blue spots in the skin reached the maximum value after rats were sensitized for 0.5-3 h. Moreover,the shape,color and size of blue spots were better 30-60 min after stimulation. CONCLUSION Optimized PCA is as follows:1-2 month-old rats are immunized on the 1st,3rd and 5th days by ip injection of OVA 1.0-5.0 mg. The immunizing serum is collected at 12-16 d after final immunization. The rats are stimulated by OVA and Evans blue after a latent period of 0.5-3 h. Diameters of blue spots in rats′ skin are then measured 30-60 min after stimulation.

Objective To explore the impact of healthcare-associated septicemia (HAS)on hospitalization expense as well as length of hospital stay,so as to optimize the allocation of healthcare resources,and provide scientific basis for reducing the economic burden caused by septicemia.Methods Hospitalized patients with confirmed HAS in a tertiary first-class teaching hospital between June 1 ,2012 and May 31 ,2015 were investigated retrospectively,con-trol group was set up in a 1 :1 ratio,hospitalization expense and length of hospital stay between two groups were compared.Results A total of 285 cases and 285 controls were enrolled in the study,the median of hospitalization expense in case group was higher than control group (￥19 718.39 vs ￥9 289.04,P <0.05);the median of length of hospital stay in case group was longer than control group (14.89 days vs 9.22 days,P <0.05).The disease bur-den caused by septicemia in different age groups and departments were different.The improvement rate of case group was lower than control group (76.49% [218/285 ]vs 83.51 % [238/285 ],χ2 = 2.562,P = 0.009 ). Conclusion As the common blood stream infection in hospitalized patients,septicemia not only increased the ex-pense of diagnosis and treatment,but also affected turnover rate of hospital bed.Rapid and effective diagnosis and treatment is significant o prevent and control septicemia.

Objective To analyze the MRI features of Brucella spondylitis and spinal tuberculosis,to improve the ability of differential diagnosis. Methods MRI features of 22 cases with Brucella spondylitis and 26 cases with spinal tuberculosis confirmed by laboratory examination and operative pathology were analyzed retrospectively.Results Among 22 cases of Brucella spondylitis,1 7 cases occurred in the lumbar spine (1 3 cases in the lumbar 4 vertebrae),2 cases in the cervical spine,2 cases in the thoracic spine and 1 case in the sacral spine.1 9 cases had normal vertebral morphology,slight bone destruction and extensive edema,3 cases had severe vertebral wedge deformation, 16 cases had marginal bone hyperplasia.15 cases had slight changes in the intervertebral space,with narrow (or normal)or slight destruction of intervertebral disc,7 cases had severe narrowing or disappearance of intervertebral space and serious destruction of intervertebral disc. 13 cases had small paravertebral abscess,and 1 case had large paravertebral abscess.Among 26 cases of spinal tuberculosis,20 cases occurred in the lumbar spine (11 cases in the 4th and 5th vertebral bodies),5 cases occurred in the thoracic spine and 1 case occurred in the sacral spine,21 cases had severe vertebral wedge deformation due to bone destruction,9 cases had slight narrowing of intervertebral space, slight destruction of intervertebral discs,and 1 7 cases had obvious narrowing or narrowing of intervertebral space.7 cases had small paravertebral abscess and 1 6 cases had large paravertebral abscess with flowing phenomenon.Conclusion Vertebral morphology of Brucella spondylitis is basically normal,bone destruction is light and edema range is large,bone hyperplasia is common,slight narrowing (or normal)of intervertebral space occurs in intervertebral disc with less destruction,range of paravertebral abscess is limited.Bone destruction of spinal tuberculosis is heavy and edema range is small,vertebral body is easy to deform with no osteoporosis,significant stenosis (or disappearance)and severe disruption occur in intervertebral disc,paravertebral abscess is large often with flowing phenomenon.

Objective To investigate the MRI features of solitary fibrous tumors(SFT)in the spinal canal.Methods MRI images of 5 cases with pathologically proved STF in the spinal canal were analyzed retrospectively.Results Of 5 lesions,there were 2 in the cervical spine,3 in the thoracic spine;1 in the epidural space and 4 in the subdural extramedullary space.On MRI plain scan,3 lesions showed homogeneous iso-intense signal on T1WI and hypo-intense signal on T2WI,2 lesions showed heterogeneous signal,1 showed patchy hypo-intense signal on T1WI and T2WI at the upper edge of lesion,which had been confirmed as hemorrhage and the other lesion showed internal cystic variation.All of the 5 lesions enhanced on enhancement scan,with moderate enhancement in 2 lesions and significant enhancement in 3 lesions.Cystic and hemorrhagic area were not enhanced.The"dural tail sign"was showed in 3 cases.Conclusion The diagnosis of SFT should be considered when a lesion shows a localized solitary mass in the spinal canal with hypo-intense on T2WI and moderate to significant enhancement.

ObjectiveTo investigate the status and influencing factors of medication adherence in patients with severe mental disorders in Zhengzhou， so as to provide references for the formulation of prevention and treatment measures for severe mental disorders. MethodsFrom March to June 2021， a stratified multistage cluster sampling method was applied to select 342 patients from the National Information System for Severe Mental Disorders in Zhengzhou. The general demographic data of patients were collected via self-designed questionnaire， and the medication status was investigated， then the influential factors were summarized. The differences in influential factors of medication adherence were compared between the medication adherence group and the medication non-adherence group. Thereafter， Logistic regression analysis was applied to explore the factors influencing medication adherence. ResultsA total of 320 patients were included in the final analysis， altogether 76.56% of patients （n=245） complied with medication. The differences between patients in the medication adherence group and those in the medication non-adherence group were statistically significant in terms of residence， occupation， and outpatient chronic disease reimbursement （χ²=14.015， 7.502， 13.106， P<0.05 or 0.01）. In the questionnaire of influential factors on medication adherence， there were statistically significant differences in the scores of lack of insight， stigma and drug-related factors between the two groups （Z=7.588， 2.379， 2.893， P<0.05 or 0.01）. Outpatient chronic disease reimbursement was a protective factor for medication adherence （OR=2.727， 95% CI： 1.320~5.634， P<0.01）， while rural residence （OR=0.465， 95% CI： 0.221~0.977， P<0.05） and lack of insight （OR=0.398， 95% CI： 0.286~0.553， P<0.01） were risk factors for medication adherence. ConclusionPatients with severe mental disorders in Zhengzhou have a high rate of medication adherence， moreover， the outpatient chronic disease reimbursement， lack of insight and residence may be influencing factors for medication adherence in patients with severe mental disorders.