Objective To discuss the application effect of FMEA in reduction of unplanned extubation of PICC.Methods FMEA was applied to find out the failure mode of unplanned extubation of PICC,and then assessed it from three dimensions,which were the likelihood of occurrence,the possibility of being discovered,and the seriousness of the failure,and then calculated the RPN values,risk priority,and plan optimization process,at the last made a proactive behavior intervention.81 patients were selected as the control group before the application of FMEA and 98 patients were set as the experimental group after the application of FMEA.The incidence of unplanned extubation was compared between two groups.Results There was statistically significant difference in unplanned extubation between two groups.Conclusions Application of FMEA can reduce the rate of unplanned extubation of PICC.

The paper analyses the influencing factors of Physician-Patient communication from three respects,some feasible measures on the mutual communication between doctors and patients are also raised in order to improve Physician-Patient relationship.

Objective The predictive value of the metabolic syndrome (MetS) for mortality from all-cause and cardiovascular disease (CVD) in the Chinese population is unclear. The aim of this present study was to compare MetS with its individual components as predictors of mortality in Chinese elderly adults. Methods A cohort of 1,535 subjects (994 men and 541 women) aged 50 years or older was selected from employees of a machinery factory in 1994 and followed until 2009. Cox models were used to estimate the hazard ratios (HRs) predicted by MetS according to the harmonized definition and by its individual components. Results The baseline prevalence of MetS was 28.0% in men and 48.4% in women. During a median follow-up of 15 years, 414 deaths occurred, of these, 153 participants died from CVD. Adjusted for age and gender, the HRs of mortality from all-cause and CVD in participants with MetS were 1.47 (95% confidence interval (CI): components. On evaluating the MetS components individually, we found that, independent of MetS, only hypertension and impaired glucose predicted higher mortality. Conclusions The number of positive MetS components seems no more informative than classifying (dichotomous) MetS for CVD risks assessment in this Chinese cohort.

This study is to investigate protective effect of safflor yellow B (SYB) against vascular endothelial cells (VECs) injury induced by angiotensin-II (Ang-II). VECs were cultured and divided into six groups: control group, Ang-II group, Ang-II + SYB (1 micromolL(-1)) group, Ang-II + SYB (10 micromolL(-1)) group, Ang-II + SYB (100 micromolL(-1)) group and Ang- II + verapamil (10 micromolL(-1)) group. Except control group, all of VECs in other groups were treated with Ang- II at the final concentration of 0.1 micromolL(-1). Mitochondria membrane potential (MMP) and free calcium concentration ([Ca2+]i) were measured by laser scanning confocal microscopy, and mitochondria complex IV activity was detected by BCA method. The levels of reactive oxygen species (ROS) in VECs were analyzed by fluorescence detector and apoptosis of VECs was observed by flow cytometer. Caspase 3 was determined by Western blotting method. Comparing with control group, Ang-II was able to increase [Ca2+]i and ROS level, decrease MMP level, inhibit complex IV activity and enhance caspase 3 activity in VECs, as a result, enhance apoptosis of VECs. But SYB could significantly reduce the result induced by Ang- II relying on different dosages (P < 0.05 or P < 0.01). SYB was able to eliminate the effect of Ang-II on VECs via regulating [Ca2+]i, mitochondrial structure and function and inhibiting apoptosis.

OBJECTIVETo observe the short-term clinical effectiveness of bone ring graft technique and to summarize the key points of related surgical operation to provide comprehensive clinical guidelines.

METHODSFifteen patients with severe alveolar bone absorption were selected to receive bone ring grafting and immediate dental implant. Final fixed prostheses were cemented five months after initial implantation. Cone beam CT scans were conducted on all subjects before the procedure, as well as four months post-operation to evaluate alveolar bone height and level of bone height and absorption around the implants. Four to six months after prosthesis installation, each implant's Jemt classification, gingiva attachment, and probing depth (PD) were analyzed. The difference of PD between implants and adjacent teeth, as well as the difference of the bone absorption between labial and lingual sides, was compared. The survival rate of the bone ring and the retention rate of implants were calculated. Complications and patient satisfaction were also investigated.

RESULTSBone graft survival rate was 94.4% and dental implantation retention rate was 100% four months post-operation. Average bone level increase was (6.06 +/- 1.06) mm, average bone absorption was (1.33 +/- 0.84) mm, and average bone thickness at the neck of the dental implant body was (6.94 +/- 0.73) mm. Approximately 4 to 6 months after crown restoration, average bone level increase was (5.62 +/- 1.03) mm, average bone absorption was (1.51 +/- 1.02) mm, and average bone thickness at the neck of the dental implant body was (6.77 +/- 0.72) mm. The PD around the implant body and the adjacent teeth was statistically insignificant. No major post-operative complication was observed, restorations were successful, and patient satisfaction level was high.

CONCLUSIONBone ring graft technique and immediate dental implantation are relatively simple to perform, and these techniques facilitate reduction in required treatment time. Short-term effect is reliable and satisfactory, whereas long-term outcomes require further follow up and study.

ObjectiveTo evaluate the clinical value of prenatal ultrasonography combined with maternal serology screening for chromosomal abnormality in 15 to 20+6 gestational weeks.MethodsSix hundred and twenty-eight pregnant women (628 fetuses) in 15 to 20+6 gestational weeks were selected to undergo prenatal ultrasonography, who were in critical risk of trisomy 21 or trisomy 18 by maternal serology screening. Transabdominal ultrasonography were performed and fetal nasal bone and nuchal fold were detected. Those who had nasal bone hypoplasia, thickened nuchal fold (NF>6 mm) and other abnormal fetal soft markers underwent amniocentesis for karyotyping analysis. ResultsThere were 6 cases of nasal bone hypoplasia (0.96%, 6/628), including one case of thickened nuchal fold, two cases of echogenic bowel, two cases of choroid plexus cysts and 1 case of echogenic cardiac focus. All these 6 cases underwent amniocentesis and 2 were trisomy 21 (33.3%, 2/6). The other 4 cases had no significant chromosomal abnormality.ConclusionsPrenatal ultrasonography may improve the detection rate of chromosomal abnormality for those pregnant women who are in critical risk of chromosomal abnormality prompted by serology screening. But invasive procedures are still needed to verify the chromosomal abnormality.

OBJECTIVETo explore the correlation between expression of mitogen-activated protein kinase kinase 4 (MKK4) and metastasis of oral squamous cell carcinoma (OSCC).

METHODSExpression levels of MKK4 mRNA and protein were examined in surgically resected oral squamous cell carcinoma specimens and corresponding lymph nodes by semi-quantitative reverse Transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry.

RESULTSThe expression of MKK4 in 48 cases of metastasis of lymph node group was significantly higher than 27 cases of without metastasis of lymph node group in 75 cases of paraffin-embedded OSCC samples (P < 0.05). The expression of MKK4 in 48 cases of metastatic lymph node lesions was higher than 48 cases of primary site of OSCC (P < 0.05). There was no correlation between the expression of MKK4 and primary site, size of tumor, histological grade ( P > 0.05). The expression of MKK4 mRNA in 16 cases of metastasis of lymph node group was significantly higher than 22 cases of without metastasis of lymph node group in 38 cases of fresh OSCC samples (P < 0.01). The expression of MKK4 in 6 cases of matched metastatic lymph node lesions was higher than 16 cases of primary tumour (P < 0.05)

CONCLUSIONThe up-regulation of MKK4 protein and mRNA may be related with the invasion and metastasis of OSCC. MKK4 maybe played a promoting role in the progression and metastasis of OSCC.

Objective To explore the effect of comprehensive nursing intervention on ICGR15, psychological ability and self-care ability of patients with hepatocellular carcinoma treated by transcatheter hepatic arterial chemoembolization.Methods A total of 140 patients received transcatheter hepatic arterial chemoembolization in our hospital were divided into control group (n=70) and experimental group (n=70) according to the different nursing methods.The control group received routine nursing care and the experimental group received comprehensive nursing intervention.The ICGR15 level, psychological ability and self-care ability of two groups were observed and compared.The postoperative complications were recorded.Results After nursing, the ICGR15 level in the experimental group was significantly lower than that in the control group(P<0.01).The psychological ability and self-care ability of the experimental group were better than that of the control group(P<0.01).The total complication rate of the experimental group was 12.86% (9/70), which was significantly lower than 34.29%(24/70) of the control group, and the differences were statistically significant (P<0.01).Conclusion Comprehensive nursing intervention can effectively reduce the damage of liver reserve function and the incidence of complications, and improve the patient''s psychological and self-care ability.So it is worthy of clinical promotion.

Objective To explore the effect of comprehensive nursing intervention on ICGR15, psychological ability and self-care ability of patients with hepatocellular carcinoma treated by transcatheter hepatic arterial chemoembolization.Methods A total of 140 patients received transcatheter hepatic arterial chemoembolization in our hospital were divided into control group (n=70) and experimental group (n=70) according to the different nursing methods.The control group received routine nursing care and the experimental group received comprehensive nursing intervention.The ICGR15 level, psychological ability and self-care ability of two groups were observed and compared.The postoperative complications were recorded.Results After nursing, the ICGR15 level in the experimental group was significantly lower than that in the control group(P<0.01).The psychological ability and self-care ability of the experimental group were better than that of the control group(P<0.01).The total complication rate of the experimental group was 12.86% (9/70), which was significantly lower than 34.29%(24/70) of the control group, and the differences were statistically significant (P<0.01).Conclusion Comprehensive nursing intervention can effectively reduce the damage of liver reserve function and the incidence of complications, and improve the patient''s psychological and self-care ability.So it is worthy of clinical promotion.

OBJECTIVEThe aim of this study is to optimize conditions for labeling human periodontal ligament stem cells (PDLSCs) using enhanced green fluorescent protein (eGFP) infected by lentivirus vector and to obtain PDLSCs with high stable expressed eGFP.

METHODSPDLSCs were transfected with eGFP by lentivirus vector for 48 h via different multiplicity of infection (MOI) (25, 50, 100, 200 and 400) and the infection efficiency were analyzed by both fluorescent microscope and flow cytometry. The proliferation rate of infected PDLSCs was evaluated by MTT. The infected PDLSCs were further for detection of pluripotent, differentiation ability and alkaline phosphatase (ALP) expression ability.

RESULTSThe infection efficiency for each group were 44.7%, 60.9%, 71.7%, 85.8% and 86.9% respectively. Proliferation of PDLSCs was not affected when MOI was below 200; however, at MOI 400, the proliferation ability was affected compared with control group. The pluripotent and ALP abilities of PDLSCs were not changed by the infection.

CONCLUSIONInfection for 48 h at MOI 200 is optimal for labeling PDLSCs with eGFP using lentivirus vector, and the proliferation and differentiation abilities of PDLSCs are not affected obviously.