OBJECTIVE:To investigate the application and feasibility of the PDCA cycle management method in pharmacy management of three-level general hospital re-accreditation in our hospital and promote continuous improvement of hospital pharma-cy management. METHODS:Referring to 2011 edition of Detailed Rules for Three-level General Hospital Accreditation,the work of hospital pharmacy management was checked and continually improved based on the PDCA cycle management method. RE-SULTS:After the application of PDCA,prescription error rate in outpatient pharmacy dropped from 0.0314% to 0.0192%;the number of dispense error in center pharmacy decreased by 60.2% and the accuracy rate of drug stock increased from 87.14% to 97.32%;the number of dispensing errors in pharmacy intravenous admixture service reduced from 5.6 bags/week to 1.8 bags/week, and the error rate reduced by 67.86%;the proportions of irrational prescriptions of glucocorticoid drugs dropped from 19.26% to 4.23%. CONCLUSIONS:The application of PDCA cycle management method in pharmacy management of three-level general hos-pital reaccreditation and the establishment of relevant system can obviously improve the work of pharmacy management continuously.

Hearing Loss ; diagnosis ; Humans ; Tomography, X-Ray Computed ; Tympanoplasty ; adverse effects

To establish a new method for simultaneously determining the content of five gingerol compounds in different processing degrees of ginger charcoal and PCA principal component analysis was conducted for analysis. Samples were analyzed on Ultimate TM XB-C18 column (4.6 mm x 250 mm, 5 μm) , with acetonitrile (A) -0.1% phosphoric acid solution (B) as mobile phase for gradient elution. Detection wavelength was set at 280 nm. The flow rate was 0.6 mL x min(-1) and the column temperature was 30 degrees C. The five compounds were separated well and showed good linearity (r ≥ 0.999 7) within the concentration ranges tested. The average value for recoveries was between 98.86% - 101.5% (RSD 1.4% - 2.9%). The contents of five compounds showed difference among different processing degrees of ginger charcoal. Zingiberone had the highest content in the standard carbon, and the content of gingerol was decreased as the deepening of processing degree. Different processing degrees of ginger charcoal were classified into three groups with PCA, and provided scientific basis for establishing the quality standards of ginger charcoal.
Catechols ; chemistry ; Charcoal ; chemistry ; Chemistry, Pharmaceutical ; methods ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; Fatty Alcohols ; chemistry ; Ginger ; chemistry ; Principal Component Analysis ; methods

Objective To investigate the capillary blood volume (BV) changes in acute ischemic denervated hindlimb of rabbits and the value of 256-slice detector computed tomography (CT) perfusion imaging in evaluation.Methods A total of 40 healthy, adult white rabbits underwent either right hindlimb femoral artery excision combined femoral nerve denervation (combined modeling group, n = 10), simple femoral artery excision (iachemia group, n = 10), simple femoral nerve denervation (denervation group,n = 10), or simple femoral artery separation (sham-surgery group, n = 10).At 1,7, 14, 21, and 28 days following surgery, CT perfusion scanning (Philips Brilliance 256-row) was performed and CT perfusion images were processed using maximum-slope method with Function CT software on EBW workstation.The ratio of BV (rBV) in muscle tissue between right and left hindlimbs was calculated in each group.At 14 and 28 days, following sacrifice, rabbit bilateral adductor was harvested for immunohistochemical staining.The ratio of microvessei density (rMVD) in muscle tissue between right and left hindlimbs was calculated.The significance of the difference of rBV at each time point was assessed using analysis of variance of factorial design (2 ×2).Pearson correlation analysis was used to study the relationship between rBV and rMVD.Results After surgery, the 1st day rBV of combined modeling group, combined modeling group,denervation group and sham-surgery group is 0.31 ± 0.15 ( n = 6), 0.29 ± 0.12 (n = 6), 0.98 ± 0.08 ( n =6), 0.98 ± 0.07 ( n = 6) respectively.The 7th day following surgery rBV is 1.69 ± 0.45 ( n = 5 ), 1.63 ±0.43(n=6), 0.99 ±0.07(n =6), 1.00 ±0.08(n =6).The 14th day is respectively 1.58 ±0.18(n=5), 1.49 ±0.25(n =6), 0.94 ±0.08(n =6), 1.01 ±0.05(n =6).The 21th day is 1.42 ±0.41 (n=4),1.43 ±0.31(n=4), 0.94 ±0.05(n =5), 1.02 ±0.05(n =5),and the 28th day is 1.00 ±0.25(n=4),0.99 ±0.08(n=4), 0.92 ±0.09(n =5), 1.02 ±0.13(n=5).At each time point with exception of postoperative 28 days(F(A) =0.214,P>0.05), ischemia produced main effects on rBV(F(A) =274.268,30.044,65.787,18.886 ,P < 0.01 ), while simple denervation did not show main effects on each time point.Ischemia and denervation did not yield interaction effects on each time point, rMVD from each group supported above-mentioned changes.The correlation coefficient of rBV to rMVD was r = 0.862 ( P < 0.01 ).Conclusions BV in acute ischemic denervated hindlimb of rabbits shows a dynamic change, and denervation does not obviously influence this process.256-slice detector CT perfusion imaging can be used to noninvasively and semi-quantitatively evaluate the dynamic changes of capillary bed in acute ischemie denervated hindlimb of rabbits.

Brachytherapy with 125I radioactive seed has the advantages of low dose-rate,comtinuous irradiation and repeated implantation to inhibit the replication of tumor cells,and the repeatable implantation.It has been widely used in the treatment for cervial cancer,and can also be applied to pelvic malignancies,including ovarian cancer,colorectal cancer,bladder cancer.Compared with external beam radiotherapy,it can improve the dose of target region to control tumor effectively.At the same time,it can protect the normal tissues and reduce the occurrence of complications.In this paper,we summarized the speciahy,function mechanism,complications and application status of radioactive 125I seed interstitial implantation in the treatment of pelvic malignancies.The application of three dimensional printing in brachytherapy with radioactive 125I seed was also introduced.This review can provide a reliable basis for future standardized seed implantation treatment for pelvic malignancies.

Various surgical technologies have been developed to minimize the risk of the operation. With continuous water flow being the dissector, a relatively bloodless operation and a clear view for the operator can be obtained. When applied to the adventitia and the soft tissue adjacent to the vascular structure, it is satisfying and the vessel and ureter can be protected perfectly if ligated selectively. The operation time is also shorter than the routine one. So, further studies of this technology are necessary.

Aim: To investigate gene expression spectra in human hepatoma cell line SMMC-7721 treated with gambogic acid (GA).Methods:Human cDNA microarray and RT-PCR technology were used to detect the changes in gene expression. Results: 31 genes in groups exposed to gambogic acid for 24 h and 56 genes for 48 h group were expessed differentially in comparison to the control group. Conclusior:The antitumor mechanism of GA might focus on apoptosis,metastasis as well as interfering with the cell cycle.

AIM:To evaluate the availability and our experience of intraoperative image-guidance in endoscopic nasocular operation.METHODS:Seven cases of endoscopic nasal surgery with intraoperative image-guidance were retropectively reviewed,including 3 cases of optic nerve injury;3 cases of foreign object of optic behind the eyeball;1 case of retrobulbar tumor(angeioma).RESULTS:The preoperative preparatory time would take 15 minutes,including coordination,head holder localization,conventional instrument registration.In our cases,the localization accuracy between 3-D image landmarks of navigation system and actual anatomical landmarks was less than 1.3mm.The optic nerve and other anatomical points could be orientated accurately in intraoperative procedures.No complication occurred.CONCLUSION:Nasal endoscope combined with imageguidance systems provides accurate anatomical localization of anterior skull base with enlarged operation field.It is possible for surgeons to observe important anatomical structures during endoscopic surgery.It could increase the effectiveness and decrease surgical complications,especially in complicated cases.

OBJECTIVE: To assess the effect of one-stage repair of secondary nasolabial deformity and nasal septoplasty for cleft patients on nasal airway resistance (NAR). METHOD: Using active anterior rhinomanometry, NAR was measured in eighteen patients with cleft lip and palate who suffered form one-stage repair of secondary nasolabial deformity and septoplasty at per-and-post operation. RESULT: NAR was (0.664 +/- 0.200) kPa/(s x L) before operation, (0.304 +/- 0.180) kPa/(s x L) six months after operation, and (0.396 +/- 0.250) kPa/(s x L) twelve months after operation respectively. The differences are statistically significant (P < 0.01) between the NAR before and after operation. Subjective impression score of nasal patency was 7.5 +/- 1.5 before-operation, 2.1 +/- 2.0 after-operation for six months, 3.0 +/- 2.4 after-operation for twelve months. There are significant differences in the subjective impression score of nasal patency as well (P < 0.01). CONCLUSION Correction of septal deformities play a very important role in the operation for secondary nasolabial deformity, which can decrease NAR and improve the subjective impression of nasal patency.
Adolescent ; Airway Resistance ; Cleft Lip ; surgery ; Cleft Palate ; surgery ; Female ; Humans ; Male ; Nasal Septum ; abnormalities ; surgery ; Nasopharynx ; surgery ; Postoperative Period ; Rhinoplasty ; Young Adult

Objective:To explore the independent prognostic factors of primary osteosarcoma patients under 20 years old after radical surgery, so as to predict the prognosis and survival of patients.Methods:The clinicopathological data of 1 339 patients with primary osteosarcoma diagnosed and registered in the National Cancer Institute Surveillance, epidemiology and outcome database (SEER) from 1984 to 2014 were retrospectively analyzed. Kaplan Meier method was used to calculate the survival rate of patients. Log rank test was used to evaluate the survival difference. Cox multivariate analysis was used to determine the independent prognostic factors of osteosarcoma after radical surgery factor.Results:The results of primary osteosarcoma patients undergoing radical surgery found that 34 cases (2.54%) aged 0-5 years old, 236 cases (17.63%) aged 6-10 years old, and 600 cases (44.81%) aged 11-15 years old and 469 cases (35.02%) aged 16-20 years old. The median survival time was 68 months. Among them, 757(56.53%) were male and 582(43.47%) were female. Among the 1 339 cases, 986 were white (73.64%), followed by black 230(17.18%), and 123 other races (9.18%). Multivariate analysis revealed that males ( HR=1.242; 95% CI:1.024-1.505), axial osteosarcoma ( HR=1.589; 95% CI:1.179-2.166), and regional invasion of osteosarcoma ( HR=1.470; 95% CI:1.156-1.870), distant metastasis ( HR=3.536; 95% CI:2.725-4.589) were independent risk factors for overall survival. Other types of osteosarcoma ( HR=0.471; 95% CI:0.285-0.779) were independent protective factors for overall survival. Conclusions:Based on the SEER database, this study identified independent prognostic factors for patients with primary osteosarcoma under the age of 20 who underwent radical surgery, which will help clinicians formulate individualized medical strategies and predict patients′ prognosis.