OBJECTIVE: To investigate the perception of surgeon to ADR reporting system. METHODS: Postal questionnaire was used for survey among 300 surgeons in November 2009. RESULTS & CONCLUSIONS: Surgeons mastered a little knowledge about ADR reporting system. More than 50% of surgeons took one-side view on national ADR monitoring with ADR reporting rate of 42.8%. 57.2% of surgeons hadn’t received relevant training. It is suggested that surgeons receive training and education about the knowledge of ADR reporting.

[Objective]To study the effect of()~(60)Co-irridiated and ethylene oxide sterilization on acellular Achilles tendon-bone biomechanical properties.[Method]Twelve fresh Achilles tendon-bone were harvested from New-Zealand white rabbits.Those tendons were soaked in 1%TnBP[tri(n-butyl)phosphate] for 48h,then they were rinsed with deionized water and ethyl alcohol.They were conducted mechanics testing after lyophilization and received()~(60)Co-irridiated or ethylene oxide sterilization.Fresh Achilles tendon-bones were as positive control.[Result]There were no significant difference between fresh and sterilized by ethylene oxide Achilles tendon-bone on biomechanical properties(P

Objective To investigate dilatancy effect of the Hypertonic Sodium Chloride Hydroxythyl Starch 40 injection (HSH) for the treatment of hemorrhagic shock.Methods 70 cases with trauma induced hemorrhagic shock were randomly divided into two groups:Hypertonic Sodium Chloride Hydroxythyl Starch 40 injection group (H group), Ringer's group (R group), 35 cases in each group.Patients of H group were infused HSH10ml/kg within 30 minutes, the R group were infused Ringer's 10ml/kg at the same time.Central venous pressure (CVP), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and oxygen saturation (SpO2) were monitored before the infusion, after the infusion and finished 30 minutes separately.Na+、Cl-、K+ were examined before infusion and after infusion respectively.Results The CVP、SBP、DBP、HR and SpO2 in both groups were improved than before infusion, but those in H group is much better than R group, with statistical significance (p<0.05).The potassium was reduced moderately and sodium ions and chloride ions were increased in H group than in R group, but it was still within normal range.Conclusion Appling HSH (10ml/kg) to patients with hemorrhagic shock can be better than the compound prescription of sodium lactate.

Objective To investigate the influence factors of central venous catheter related infections (CVC-RI) in postoperative patients with gastric carcinoma treated with parenteral nutrition,in order to provide scientific basis for prevention and treatment.Methods Using the retrospective study method,150 patients who treated with parenteral nutrition after operation of gastric carcinoma from December 2013 to March 2014 were selected.Information including age,sex,anamnesis,catheter indwelling time,infusion rate of nutrient solution,and so on were collected.Patients with central venous catheter related infections were set as infection group,patients without infection as the control group,and the group logistic regression analysis was used to analyze the collected data.Results 21 patients in infection group had CVC-RI,and the incidence was 14.00％ (21/150),while 129 patients in control group had CVC-RI.Univariate analysis showed there was significant difference between infection group and control group in age,anamnesis,catheter indwelling time and infusion rate of nutrient solution (x2=17.126,5.447,12.795,7.973,P＜0.05),however there was no significant difference in sex,health insurance,the success rate of catheterization and whether glutamine was in nutrient solution (P＞0.05);the group logistic regression analysis showed that age (OR=15.927,95％CI 3.305-76.756,P＜0.05)and catheter indwelling time (OR=3.511,95％CI 1.028-11.992,P＜0.05) were independent risk factors for CVC-RI,however infusion rate of nutrient solution (OR=0.140,95％CI 0.033-0.597,P＜0.05) was a protective factor.Conclusions For the postoperative patients with gastric carcinoma treated with parenteral nutrition,CVC-RI is closely related to age,catheter indwelling time and infusion rate of nutrient solution.So reducing catheter indwelling time,restoring the enteral nutrition under condition permission as so on as possible can reduce infection of elderly patients.

Objective To observe the clinical effect of artificial ventilation combined continuous positive airway pressure(CPAP) with removal of tracheobronchial foreign bodies for children and to explore the possibility and security of the method. Methods 60 children with tracheobronchial foreign body, underwent total intravenous anesthesia ,were randomly divided into A group and B group. Each group had 30 cases. A group was given artificial ventilation with CPAP. The bronchofibroscope was connected to anesthesia machine with side hole after induction for 3 minutes,and high fresh gas flow(10 ～ 15L/min) was given to maintain continuous positive airway pressure. B group were given high frequency jet ventilation(HFJV) ,60 ～ 100 bpm. The mask ventilation was given in stand of bronchofibroscope when SpO2 ＜ 90% and until SpO2 improved. MAP, HR, ECG, SpO2, PaO2, PaCO2 were monitored and recorded at time points: T0 (entered operation room), T1 (beginning of bronchofibroscopy), T2 (5 min after bronchofibroscopy), T3 (10 min after bronchofibroscopy), T4 (end of operation). The side effects, the rate of fail to bronchofibroscopy and the rate of intubations after operation in two groups were observed and recorded. Results The HR of post-anesthesia in two groups significantly decreased than those at T0 (P ＜ 0.01), but no difference showed in HR between two groups(P ＞ 0.05). SpO2 and PaO2 of post-anesthesia in two groups significantly increased than those at T0 (P ＜0. 01) ,PaO2 at T1 ,T2 ,T3 in A group were significantly higher than those in B group(P ＜0.05). PaCO2 gradually increased after bronchofibroscopy in two groups ,and the values in A group was significantly lower than in B group(P ＜0.05 or 0. 01). There were no significant differences in the rates of fail to bronchofibroscopy and of intubations after operation between two groups, but the total number of B group was higher. Conclusion Artificial ventilation with CPAP for children with removal of tracheobronchial foreign bodies was safe and practical, and has a better controllability, a minor effect to respiratory function, deserve popularizing.

Objective:To study the clinical value of left ventricle Tei index in evaluating hemodynamics after interventional therapy of patent ductus arteriosus (PDA).Methods:From May 2017 to May 2019, 50 children with PDA who underwent interventional therapy (PDA group) and 27 healthy children (healthy control group) in Anhui Provincial Children’s Hospital were selected. The left ventricle Tei index, plasma brain natriuretic peptides (BNP), left ventricular end-diastolic dimension (LVDD), left ventricular ejection fraction (LVEF) were compared between 2 groups.Results:The left ventricle Tei index was not correlated with heart rate and age in 2 groups ( P>0.05). The left ventricle Tei index before operation in PDA group was significantly lower than that in healthy control group: 0.20(0.16, 0.25) vs. 0.27(0.20, 0.30), and there was statistical difference ( P<0.05). In PDA group, the left ventricle Tei index immediately, 3 d, 1 month and 3 months after operation was significantly higher than before operation: 0.38(0.29, 0.47), 0.32(0.26, 0.40), 0.30(0.27, 0.35) and 0.32(0.26, 0.37) vs. 0.20(0.16, 0.25), and there was statistical difference ( P<0.05); the plasma BNP immediately after operation was significantly lower than before operation: 288 (126, 433) ng/L vs. 582 (303, 1 675) ng/L, and there was statistical difference ( P<0.05); the LVDD 3 months after operation was significantly lower than before operation: (3.03 ± 0.54) cm vs. (3.38 ± 0.51) cm, and there was statistical difference ( P<0.05); the LVEF immediately after operation was significantly lower than before operation: (54.24 ± 6.09)% vs. (59.45 ± 5.93)%, the LVEF 1 and 3 months after operation was significantly higher than that immediately after operation: (63.18 ± 4.71)% and (65.46 ± 4.78)% vs. (54.24 ± 6.09)%, and there were statistical differences ( P<0.05). The left ventricle Tei index before operation was negatively correlated with inner diameter of PDA and plasma BNP ( r = -0.362 and -0.388, P = 0.013 and 0.009), and there was no correlation between LVDD and LVEF ( r = -0.192 and -0.283, P = 0.229 and 0.053); the differences of Tei index before operation and immediately after operation (ΔTei) was positively correlated with inner diameter of PDA ( r = 0.325, P = 0.030), and there was no correlation with BNP, LVDD and LVEF ( r = 0.234, 0.283 and -0.039, P = 0.126, 0.076 and 0.798). Conclusions:The left ventricle Tei index can quickly and accurately assess the change of hemodynamics after interventional therapy of PDA.

Objective To investigate the clinical and pathological characteristics of patients with chronic hepatitis B virus(HBV)infection in immune tolerant phase.Methods Ninety-eight chronic HBV carriers in immune tolerant phase were enrolled in this study.The age,gender,serum HBV DNA level,hepatic inflammatory activity and fibrosis,hepatic HBsAg and HBcAg expressions were analyzed.The grade of inflammatory activity and stage of fibrosis were also compared in patients with different levels of serum alanine aminotransferase(ALT).Data analysis was done by chi-square test. Results In 98 patients,83(84.7%)were＜30 years old and 15(15.3%)were≥30.Patients whose mother was HBsAg positive were 48.0%.High levels of serum HBV DNA were found in all patients, with 78.5% were＞1×107 copy/mL.Only 5 cases(5.1%)were G0 of the inflammatory grade;whereas,64 cases(65.3%)were G1,29(29.6%)were G2.There were 56 patients(57.1%)had no significant liver fibrosis;and 23 cases(23.5%)were S1,14(14.3%)were S2,5(5.1%)were S3;none of patients had cirrhosis.The HBsAg and HBcAg in liver tissues were positive in 79(80.6%)and 80(81.6%)cases,respectively.The fibrosis stages of patients with higher ALT levels were significantly greater than patients with lower ALT levels(X2=8.112 3,P=0.043 7).Conclusions Most of patients with chronic HBV infection in immune tolerant phase present mild inflammation in liver,some of them have already developed fibrosis.Therefore,liver pathology is recommended for these patients to help understand the patients' conditions and make correct therapeutic decisions.

According to 'National Standard of Undergraduate Teaching Quality for Nursing Science', the mode of community nursing practice was explored and implemented by the School of Nursing in Tianjin Medical University. Focus on competency, the syllabus of community nursing practice was revised. Optimizing the management system of community nursing practice, developing the team of high-quality teachers, building standardized community nursing practice bases, and improving the evaluation system of community nursing practice aimed to enhance comprehensive quality of nursing undergraduates and the quality of community nursing practice. Within the concept of "big health", our school is exploring the new mode of combining community nursing practice with health management-oriented nursing personnel training, which lays an important foundation for training applied nursing talents to meet the needs on development of community health services.

Objective To investigate the expression of gastric and intestinal phenotypic markers in Siewert typeⅡand Ⅲ early gastroesophageal junction(GEJ) cancer, and to explore its correlation with clinic-pathological features.Methods From April 2010 to July 2015, 53 cases diagnosed as early GEJ cancer were enrolled.The gastric and intestinal phenotypic markers such as mucin5AC(MUC5AC),mucin6(MUC6),mucin2(MUC2),caudal related homeodomain transcription 2(CDX2) and cluster of differentiation 10(CD10) were detected, and then the patients were divided into gastric type, gastrointestinal type, intestinal type and non-classified type according to the results of immunohistochemical staining.Combined with Siewert classification the clinicopathological features were analyzed.Chi square test or Fisher′s exact test was performed for statistical analysis.Results In the cancer tissues of 47 patients with Siewert type Ⅱand Ⅲ early GEJ cancer, the case numbers of positive expression of MUC5AC,MUC6,MUC2, CDX2 and CD10 were 21(44.7%),19(40.4%),31(66.0%),27(57.4%) and 17(36.2%),respectively;the case numbers of gastric type, gastrointestinal type, intestinal type and non-classified type were 11(23.4%),14(29.8%),21(44.7%) and one(2.1%), respectively.The positive expression rates of MUC5AC and MUC6 in Siewert typeⅡwere 55.9%(19/34) and 50.0%(17/34),which were higher than those of Siewert typeⅢ(2/13), and the positive expression rate of MUC2 was 55.9%(19/34), which was lower than that of Siewert typeⅢ(12/13), and the differences were statistically significant (x2=6.240,4.679 and 4.053;all P<0.05).In Siewert typeⅡ, the proportion of intestinal type was 32.4%(11/34), which was lower than that of Siewert typeⅢ(10/13), and the differences were statistically significant (x2=7.142,P=0.010).In patients with Siewert typeⅡand Ⅲ early cancer, males predominated in intestinal type which were mostly well differentiated type with less submucosal carcinoma.The maximum diameter of tumor was less than those of gastric type and gastrointestinal type.In paracancerous mucosal tissues, the incidences of intestinal metaplasia in gastrointestinal type and intestinal type were 11/14 and 81.0%(17/21), which were higher than that of gastric type (3/11);the incidences of atrophy in gastrointestinal type and intestinal type were 12/14 and 85.7%(18/21),which were higher than that of gastric type (4/11),and the differences were statistically significant (Fisher′s exact test,all P<0.05).Conclusions Siewert typeⅡand Ⅲ early GEJ cancer can directly originated not only from gastric mucosa, but also from gastrointestinal and intestinal mucosa.Atrophy and intestinal metaplasia could exist before cancer genesis.

OBJECTIVE: To investigate the liver T1rho values for detecting fibrosis, and the potential impact of fatty liver on T1rho measurements. MATERIALS AND METHODS: This study included 18 healthy subjects, 18 patients with fatty liver, and 18 patients with liver fibrosis, who underwent T1rho MRI and mDIXON collections. Liver T1rho, proton density fat fraction (PDFF) and T2* values were measured and compared among the three groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the T1rho values for detecting liver fibrosis. Liver T1rho values were correlated with PDFF, T2* values and clinical data. RESULTS: Liver T1rho and PDFF values were significantly different (p < 0.001), whereas the T2* (p = 0.766) values were similar, among the three groups. Mean liver T1rho values in the fibrotic group (52.6 ± 6.8 ms) were significantly higher than those of healthy subjects (44.9 ± 2.8 ms, p < 0.001) and fatty liver group (45.0 ± 3.5 ms, p < 0.001). Mean liver T1rho values were similar between healthy subjects and fatty liver group (p = 0.999). PDFF values in the fatty liver group (16.07 ± 10.59%) were significantly higher than those of healthy subjects (1.43 ± 1.36%, p < 0.001) and fibrosis group (1.07 ± 1.06%, p < 0.001). PDFF values were similar in healthy subjects and fibrosis group (p = 0.984). Mean T1rho values performed well to detect fibrosis at a threshold of 49.5 ms (area under the ROC curve, 0.855), had a moderate correlation with liver stiffness (r = 0.671, p = 0.012), and no correlation with PDFF, T2* values, subject age, or body mass index (p > 0.05). CONCLUSION: T1rho MRI is useful for noninvasive detection of liver fibrosis, and may not be affected with the presence of fatty liver.
Body Mass Index ; Fatty Liver* ; Fibrosis ; Healthy Volunteers ; Humans ; Liver Cirrhosis* ; Liver* ; Magnetic Resonance Imaging ; Prospective Studies* ; Protons ; ROC Curve