Accident Prevention ; Humans ; Malpractice ; Medical Errors ; prevention & control ; Surgical Procedures, Operative

Abdominal Injuries ; etiology ; prevention & control ; Humans ; Iatrogenic Disease ; Intraoperative Complications ; prevention & control

Objective To verify the evaluation index system of clinical science and technology achievements, taking the evaluation of science and technology achievements in Guangdong province as a demonstration. Methods We specified the criteria for grading each index included in the evaluation index system that we proposed before. 5 experts in clinical medicine were invited to evaluate 20 achievements applying for the Award of Guangdong Science and Technology Achievements in 2010. The weighted sum of scores for each achievement was calculated and used for further analysis. The reliability and validation of the system were assessed. Results The Cronbach's ? coefficient of the index system was 0. 91, indicating good reliability. There were high correlation of each measure with the total score and their affiliated grade one index. The scores that the experts graded were correlated with the original results of evaluation (rs= 0. 71, P ＜0. 000 1), but there remained some inconsistence. Conclusion The demonstration based on investigation data indicates that the evaluation system is easy to handle and has satisfactory reliability and validation. It can be applied to the evaluation of science and technology achievements in clinical medicine.

Objective To set up a scientific, objective, reasonable, qualitative and quantitative,operational evaluation index system of clinical science and technology achievements, which provides the reference to evaluating clinieal science and technology achievements scientifieally. Methods The Delphi method was used to investigate 30 experts for weight of the index via questionnaire. Results The response rate was 100%. The Kendall's concordance coefficient was up to 0. 963. The final index system includes three first-class indicators, eight second-class indicators and 18 third-class indicators. The weight coefficeient of each class was identified. Conclusion The experts showed enthusiasm for this investigation. The agreement of respondents was high after two rounds of investigation. The index system can be used in comprehensive evaluation for science and technology achievements in clinical medicine. The index system takes a guiding effect for science and technology achievements to solve clinical services and problems.

Objective To investigate the clinical value of quality intima-media thicknes (QIMT),quality arterial stiffness(QAS) and XStrain in assessing the ventricular-arterial coupling (VAC) in patients with uremia.Methods Sixty-five patients with uremia and 30 normal subjects were enrolled in this study as the uremic group and control group respectively.Ultrasound examination for the cardiac and carotid artery was performed and some parameters were obtained,such as left ventricular ejection fraction(LVEF),E/e,Tei index,stiffness (β),compliance coefficinet (CC),pulse wave velocity (PWV),intima-media thicknes (IMT),strain,and so on.The sum of left ventricular systolic radial strain and carotid arterial diastolic radial strain was used as a new parameter (VACs) for assessing VAC.The correlation between VACs and VACv,a traditional method to evaluate VAC,was analyzed.The parameters obtained by ultrasonic techniques were compared between two groups.The intra-and inter-observer reliability of XStrain was assessed by intraclass correlation coefficient.The multiple linear regression and ROC curve were used to analyze the independent factor of cardiovascular dysfunction.Results ①The pulse pressure,E/e,Tei index,as well as β,PWV and IMT were larger in uremic group than control group significantly (P ＜0.05).②The function of VAC was decreased in uremic group,and the VACv and VACs were lower than control group significantly (P ＜0.05).③There was strong positive relation between VACs and VACv (r =0.908,P =0.000).The reproducibility of XStrain technique was well.④VACs,β,VACv and PWV could be considered as independent factor of cardiovascular dysfunction and performance of VACs was the largest (standardized coefficient was-0.582).A cutoff value of VACs for assessing cardiovascular dysfunction was less than 23.60,which had both higher sensitivity and specificity (96.4％,81.1％).Conclusions The QIMT,QAS and XStrain can be used to assess cardiovascular structure,function and VAC accurately and globally,which can be consider as an effective method for detecting cardiovascular complication and improving prognosis of uremic patients.

Objective To prepare serum cholesterol and triglycerides reference materials.Methods Blood units were collected from healthy donors and the sera separated and screened for cholesterol and triglycerides levels.Four serum pools were prepared by pooling sera grouped according to cholesterol and triglyceride levels.The materials were tested for homogeneity and stability and their values for total cholesterol,total glycerol and free glycerol and triglycerides were assigned by HPLC methods.Results The materials were tested to be homogeneous and stable for at least 4 years at-20℃.The certified values (reference value±expanded uncertainty)of the 4 materials for total cholesterol were(5.110±0.065) mmol/L,(4.761±0.062)mmol/L,(3.941±0.050)mmol/L and(3.158±0.041)mmol/L,respectively;for total glycerol(2.212±0.043)mmol/L,(1.679±0.033)mmol/L,(1.275±0.027)mmol/L and(1.067±0.023)mmol/L;for free glycerol(0.142±0.005)mmol/L,(0.149±0.004)mmol/L,(0.146±0.003)mmol/L and(0.122±0.003)mmol/L;and for triglycerides(2.069±0.043)mmol/L,(1.530±0.033)mmol/L,(1.129±0.027)mmol/L and(0.945±0.023)mmol/L.Conclusion Certified reference materials for serum total cholesterol,total glycerol,free glycerol and triglycerides have been prepared.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell ; genetics ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Kidney Neoplasms ; genetics ; metabolism ; Male ; Matrix Metalloproteinase 2 ; genetics ; metabolism ; Middle Aged ; Transforming Growth Factor beta1 ; genetics ; metabolism ; Tumor Cells, Cultured ; Young Adult

OBJECTIVETo analyse the imaging characteristics of the irreducible femoral intertrochanteric fracture and evaluate the operative effect of closed poking reduction and intramedullary nail fixation.

METHODSFrom December 2011 to October 2015, 28 patients with irreducible femoral intertrochanteric fracture were treated by closed poking reduction and intramedullary nail fixation including 12 males and 16 females with an average age of 72 years old ranging from 58 to 89 years old. According to AO classification: 5 cases were type A2.1, 10 cases were type A2.2, 13 cases were type A3.3. The postoperative complications were observed, and the postoperative X ray were used to evaluate the fracture healing, and the Harris score was used to evaluate the hip joint function.

RESULTSPreoperative X rays for determine irreducible femoral intertrochanteric fracture was difficult, but dimensional CT had characteristic performance: the fracture near the end displaced forward rotation. Operation time was 45 to 100 minutes with an average of 65 minutes. Intraoperative bleeding was 80 to 300 ml with an average of 160 ml. Two cases died within 3 months after operation, 26 patients were followed up for 6 to 12 months with an average of 8.4 months. Fracture healing time was 12 to 16 weeks with an average of 13.6 weeks. Two cases occurred inversion deformity.There were no wound infection, nonunion and fracture fixation failure. Hip Harris score was 86.7±5.3 at the last follow up, the result was excellent in 14 cases, good in 12 cases.

CONCLUSIONSDimensional CT can be very good to predict the fracture of the irreducible femoral intertrochanteric fracture. Closed poking reduction and intramedullary nail fixation for the treatment of the irreducible femoral intertrochanteric fracture has satisfactory clinical result.

OBJECTIVETo study the chemical constituents in the root of Isatis indigotica.

METHODThe constituents root were separated through various chromatographic techniques and their structures were elucidated by means of physicochemical properties and the analysis of their spectral data.

RESULTEleven compounds were isolated and identified as (+) -isolariciresinol (1), lariciresinol (2), lariciresinol-9-O-beta-D-glucopyranoside (3), lariciresinol-4'-O-beta-D-glucopyranoside (4), lariciresinol-4,4'-bis-O-beta-D-glucopyranoside (5), 3-formylindole (6), 1-methoxy-3-indolecarbaldehyde (7), 1-methoxy-3-indoleacetonitrile (8), deoxyvasicinone (9), epigoitrin (10), adenosine (11).

CONCLUSIONCompounds 4-8 were isolated from I. indigotica for the first time.

Furans ; analysis ; chemistry ; isolation & purification ; Glucosides ; analysis ; chemistry ; isolation & purification ; Indoles ; analysis ; chemistry ; isolation & purification ; Isatis ; chemistry ; Lignans ; analysis ; chemistry ; isolation & purification ; Lignin ; analysis ; chemistry ; isolation & purification ; Naphthols ; analysis ; chemistry ; isolation & purification ; Plant Extracts ; analysis ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Spectrometry, Mass, Electrospray Ionization

OBJECTIVEThe pathogenesis of irritable bowel syndrome (IBS), a functional gastrointestinal disorder, is poorly understood. Treatment by Chinese medicine and pharmacy (CMP) is superior to treatment by Western medicine (WM). Therefore, we aimed to analyze Chinese medical experts' experiences in treating IBS by data mining.

METHODSBy retrieving related literatures from 1994 to 2012 from CNKI, we chose proved cases and screened effective medical records to establish a database using structural electronic medical case collecting system and data mining. The thinking ways of modern physicians in diagnosis and treatment of IBS were analyzed.

RESULTSTotally 116 medical cases from 46 Chinese medical experts were recruited and analyzed. Results showed that Gan depression and Pi deficiency were most basic syndrome elements. In addition, cold dampness, damp heat, yang deficiency, and Shen deficiency were main elements for the development of diarrhea predominant IBS (IBS-D). Qi stagnation, yin deficiency, qi deficiency, and blood stasis were main elements for the development of constipation predominant IBS (IBS-C). Soothing Gan-qi and strengthening Pi was the most important treatment method. White peony root, prepared atractylodes, prepared licorice, tangerine peel, poria, bupleurum, Radix sileris, lanceolata, and Radix aucklandiae were the most common Chinese herbs used in treating IBS.

CONCLUSIONS(1) Gan depression and Pi deficiency was the main pathogenesis for IBS. Diagnosis and treatment of IBS should be performed clinically according to its development. Tongxie Yao-fang should be used as the basic prescription with modification according to syndrome differentiation. (2) Data mining will have a wide application prospect in studying medical cases.

Data Mining ; Humans ; Irritable Bowel Syndrome ; diagnosis ; drug therapy ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; methods