OBJECTIVE:To consummate the flow sheet in drug storehouse management so as to improve the management efficiency.METHODS:5S management,visible management and demand-oriented management stated in lean management were applied in drug storehouse management.RESULTS:Due to the application of the methods in lean management,the storage capability of hospital drug storehouse was increased,medicine circulation was accelerated,and the work efficiency was enhanced.CONCLUSIONS:The application of lean management theory is conducive to the upgrading of scientific management as well as the enhancing of both efficiency and performance of hospital drug management.

Objective: To investigate the efficacy and safety of a new cervical artificial disc prosthesis in the treatment of cervical degenerative diseases. Methods: The clinical data of 18 patients with single-level cervical degenerative diseases who underwent three dimensional printed anatomical bionic cervical disc replacement at Department of Spinal Surgery,Honghui Hospital,Xi'an Jiaotong University from May 2019 to July 2020 were analyzed retrospectively. There were 7 males and 11 females,aged (45±8) years old(range:28 to 58 years).The surgical segment was located at C_3－4 level in 2 cases, C_4－5 level in 5 cases, C_5－6 level in 9 cases, and C_6－7 level in 2 cases.The clinical and radiographic outcomes were recorded and compared at preoperative,postoperative times of one month and twelve months.The clinical assessments contained Japanese orthopedic association (JOA) score,neck disability index (NDI) and visual analogue scale (VAS).Imaging assessments included range of motion (ROM) of cervical spine, prosthesis subsidence and prosthesis anteroposterior migration.Repeated measurement variance analysis was used for comparison between groups,and paired t test was used for pairwise comparison. Results: All patients underwent the operation successfully and were followed up for more than 12 months.Compared with preoperative score,the JOA score,NDI and VAS were significantly improved after surgery (all P<0.01).There was no significant difference in postoperative ROM compared with 1-and 12-month preoperative ROM (t=1.570,P=0.135;t=1.744,P=0.099). The prosthesis subsidence was (0.29±0.13) mm (range: 0.18 to 0.50 mm) at 12-month postoperatively.The migration of prosthesis at 12-months postoperatively were (0.71±0.20) mm (range: 0.44 to 1.08 mm).There was no prosthesis subsidence or migration>2 mm at 12-month postoperatively. Conclusion: Three dimensional printed anatomical biomimetic cervical artificial disc replacement has a good early clinical effect in the treatment of cervical degenerative diseases, good mobility can be obtained while maintaining stability.
Adult ; Biomimetics ; Cervical Vertebrae/surgery* ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc/surgery* ; Intervertebral Disc Degeneration/surgery* ; Male ; Middle Aged ; Range of Motion, Articular ; Retrospective Studies ; Total Disc Replacement/methods* ; Treatment Outcome

Objective: To develop an indicator system for assessing public hospital performance. Methods:Based on literature research and expert consultation, we formed an indicator system framework and indicators for as-sessing public hospital performance. Using Delphi expert consultation, focus group interviews, focus group discussion and individual in-depth interview qualitative research methods, we constructed a public hospital performance evalua-tion indicators. Results:There are four dimensions, 11 secondary indicators, 30 tertiary indicators in the indicator system, depending on the level of hospital, the indicators and weights are adjusted. Conclusion:The indicator system is suitable for public-interest-oriented performance assessment of public hospitals, and provides basis for the perform-ance assessment system.

Objective To investigate the clinical outcome of arthroscopic percutaneous cannulated screw fixation with subtalar fusion in the treatment of post-traumatic subtalar arthritis. Methods The study involved 12 patients (five males and seven females) with severe post-traumatic subtalar arthritis admitted to our hospital from April 2006 to December 2009. The patients were at age range of 28-68 years ( mean 45.6 years). All patients had the history of conservative treatment but failed in pain alleviation.Then, the percutaneous cannulated screw fixation plus subtalar fusion was selected. The ande and hind foot of all patients were evaluated preoperatively and postoperatively by the American Orthopedic Foot and Ankle Society (AOFAS) scoring system. Imaging assessment was carried out by X-ray examination.Results The patients were followed up for mean 21.2 months (range 6-48 months), which showed thatthe mean AOFAS ankle-hindfoot scale was increased from (54.67 ± 5.28 ) points (range 43-61 points)preoperatively to (89.17 ±3.56) points (range 78-95 points) at final follow-up, with excellence rate of 93%. Eleven patients got good fusion with the mean time of 12.4 weeks (range 9-15 weeks). Only one patient had nonunion, with the pain in the lateral malleolus. The subtalar joint of the patient got union after plaster immobilization for three months, which was proved by X-ray examination. Conclusions The arthroscopic percutaneous cannulated screw fixation and subtalar fusion can acquire good clinical outcomes and hence is a recommended procedure for post-traumatic subtalar arthritis.

Objective To investigate the expression of Akt and phosphoryled Akt (p-Akt1) protein in pancreatic carcinoma and to determine the clinical significance. Methods In 74 cases of pancreatic carcinoma and 10 cases of normal pancreatic tissue samples, the expression of Akt and p-Akt1 were detected by immunohistochemical method, and the its relationship with clinicopathologic characteristics and prognosis were analyzed. Results The positive expression rate of Akt and p-Akt1 in pancreatic carcinoma were 87.8% and 83.8% respectively, while there was no expression of Akt and p-Akt1 in normal pancreatic tissue, and the difference was statistically significant (p < 0.05). There was a positive correlation between the expression of Akt and p-Akt1 in pancreatic carcinoma (r =0.274, P =0. 018). The expression of Akt and p-Akt1 was not significantly associated with the age, sex, location, size, pathology stages, lymph nodes metastasis, clinical stages and nerve invasion of the tumor (P >0.05). But the higher expression of p-Akt1 was associated with T stages and TNM staging (p =0. 002). Patients with high intensity of Akt and p-Akt1 expression showed a significantly longer median survival time [(16.0 ± 5.7) month and (23.0 ± 5.5) month, respectively]than those with low intensity expression [(9.3 ± 0.2) month and (11.1 ± 1.8) month (P = 0. 007 and P = 0.004) respectively]. Conclusions p-Akt1 expression is a significant positive prognostic factor for pancreaticcarcinoma and detection of p-Akt1 expression may be of clinical value.

BACKGROUNDAfter total hip arthroplasty (THA), there is a noteworthy inflammatory response. The inflammatory response is associated with postoperative recovery and complications. However, there had been few reports on the relationship between inflammatory response and postoperative complication rate. The aim of the present study was to investigate early inflammatory response in the first 3 days after THA, and to identify the relationship between inflammatory response and estimated complication rate after surgery.

METHODSIt was a prospective, nonrandomized cohort study. There were 148 patients who underwent unilateral THA in our hospital enrolled. Blood samples were collected preoperatively in the morning of the surgery and at 24, 48, and 72 h after surgery. C-reactive protein (CRP) and interleukin-6 (IL-6) in peripheral blood were measured. The modified physiological and operative severity score for the enumeration of the morbidity (POSSUM) was recorded pre- and intra-operatively. Based on the score, estimated complication rate was calculated. Harris score was used to assess hip function before and after surgery.

RESULTSIL-6 levels reached the peak at 24 h after surgery and CRP at 48 h. After that, both of the levels decreased. The mean Harris scores significantly increased from 41.62 ± 23.47 before surgery to 72.75 ± 9.13 at 3 days after surgery. The Harris scores after surgery did not have a significant relation with either IL-6 or CRP peak levels (P = 0.165, P = 0.341, respectively). Both CRP and IL-6 peak levels significantly and positively correlated with estimated complication rate after surgery. The estimated complication rate calculated using the POSSUM system was 43 cases of 148 patients. Actually, there were only 28 cases that were observed to get postoperative complications during hospitalization. However, there was no significant difference between estimated and observed complication rates (P = 0.078). In the group with complications, the CRP and IL-6 peak levels were significantly higher than those in the group without complications (both P< 0.001).

CONCLUSIONSThere were significantly positive relationships between both peak levels of CRP and IL-6 and estimated complication rate after THA. Inflammatory response could predict the incidence of complications after THA.

Aged ; Arthroplasty, Replacement, Hip ; adverse effects ; Biomarkers ; blood ; C-Reactive Protein ; metabolism ; Female ; Humans ; Inflammation ; blood ; Interleukin-6 ; blood ; Male ; Middle Aged ; Postoperative Complications ; blood ; Prospective Studies

This study was intended to establish a method for preparation of purified and viral-inactivated placenta hemoglobin. The optimum preparative condition resulted in the up-grading of purity,recovery and so on. A quality control was also established for the purification of hemoglobin. Compared to present purification methods, this method is easy to operate, needs low investment and running cost, and has the advantage of simultaneous operation for purification and viral-inactivation. The resulted hemoglobin had high purity and recovery, and the physicochemical property measured up to that in international reports. So this method is suitable for preparing purified and viral-inactivated hemoglobin on an adequate scale, and is useful for further development of blood substitutes.
Blood Substitutes ; Fetal Blood ; chemistry ; virology ; Hemoglobins ; isolation & purification ; Humans ; Virus Inactivation

OBJECTIVETo explore the clinical features and mutation of TGFBI gene in a Chinese pedigree affected with lattice corneal dystrophy (LCD).

METHODSGenomic DNA was extracted from 35 members including 11 patients from the pedigree. The 17 exons and splicing region of introns of the TGFBI gene were amplified by PCR. The products were directly sequenced and compared with GenBank database to identify potential mutation. Bioinformatic analysis was carried out to predict the effect of mutation on proteins.

RESULTSA heterozygous mutation (p.R124C) was found in exon 4 of the TGFBI gene in all patients from the pedigree but not among unaffected members. The mode of inheritance of corneal dystrophy in this pedigree was identified as autosomal dominant. Bioinformatics analysis predicted that the p.R124C mutation may be functionally deleterious. The phenotype of corneal dystrophy in the pedigree was determined to be LCD I type.

CONCLUSIONThe p.R124C mutation of the TGFBI gene probably underlies the pathogenesis of LCD in this Chinese pedigree. Genetic testing can facilitate proper diagnosis of this type of corneal dystrophy.

Background: Reports on the efficacy of modifications to the thread design of pedicle screws are scarce. The aim of the study was to investigate initial and early fixation of pedicle screws with a plasma-sprayed titanium coating and dual pitch in the pedicle region (dual pitch titanium-coated pedicle screw [DPTCPS]) in a polyetheretherketone (PEEK) rod semi-rigid fixation system. Methods: Fifty-four sheep spine specimens and 64 sheep were used to investigate initial ( "0-week" controls) and early (postoperative 6 months) fixation, respectively. Sheep were divided into dual pitch pedicle screw (DPPS), standard pitch pedicle screw (SPPS), DPTCPS, and standard pitch titanium-coated pedicle screw (SPTCPS) groups. Specimens/sheep were instrumented with four screws and two rods. Biomechanical evaluations were performed, and histology at the implant-bone interface was investigated. Results: At 0-week, mean axial pull-out strength was significantly higher for the DPTCPS and SPTCPS than the SPPS (557.0 ± 25.2 vs. 459.1 ± 19.1 N, t = 3.61, P < 0.05; 622.6 ± 25.2 vs. 459.1 ± 19.1 N, t = 3.43, P < 0.05). On toggle-testing, the DPTCPS was significantly more resistant than the SPPS and SPTCPS (343.4 ± 16.5 vs. 237.5 ± 12.9 N, t = 3.52, P < 0.05; 343.4 ± 16.5 vs. 289.9 ± 12.8 N, t = 3.12, P < 0.05; 124.7 ± 13.5 vs. 41.9 ± 4.3 cycles, t = 2.18, P < 0.05; 124.7 ± 13.5 vs.79.5 ± 11.8 cycles, t = 2.76, P < 0.05). On cyclic loading, maximum displacement was significantly lower for the DPTCPS than the SPPS and SPTCPS (1.8 ± 0.13 vs. 3.76 ± 0.19 mm, t = 2.29, P < 0.05; 1.8 ± 0.13 vs. 2.46 ± 10.20 mm, t = 2.69, P < 0.05). At post-operative 6 months, mean axial pull-out strength was significantly higher for the DPTCPS and SPTCPS than the SPPS (908.4 ± 33.6 vs. 646.5 ± 59.4 N, t = 3.34, P < 0.05; 925.9 ± 53.9 vs. 646.5 ± 59.4 N, t = 3.37, P < 0.05). On toggle-testing, the DPTCPS was significantly more resistant than the SPPS and SPTCPS (496.9 ± 17.9 vs. 370.3 ± 16.4 N, t = 2.86, P < 0.05; 496.9 ± 17.9 vs. 414.1 ± 12.8 N, t = 2.74, P < 0.05; 249.1 ± 11.0 vs.149.9 ± 11.1 cycles, t = 2.54, P < 0.05; 249.1 ± 11.0 vs.199.8 ± 7.2 cycles, t = 2.61, P < 0.05). On cyclic loading, maximum displacement was significantly lower for the DPTCPS than the SPPS and SPTCPS (0.96 ± 0.11 vs. 2.39 ± 0.14 mm, t = 2.57, P < 0.05; 0.96 ± 0.11 vs. 1.82 ± 0.12 mm, t = 2.73, P < 0.05). Resistance to toggle testing (370.3 ± 16.4 vs. 414.1 ± 12.8 N, t = 3.29, P < 0.05; 149.9 ± 11.1 vs.199.8 ± 7.2 cycles, t = 2.97, P < 0.05) was significantly lower and maximum displacement in cyclic loading (2.39 ± 0.14 vs.1.82 ± 0.12 mm; t = 3.06, P < 0.05) was significantly higher for the SPTCPS than the DPTCPS. Bone-to-implant contact was significantly increased for the DPTCPS compared to the SPPS (58.3% ± 7.0% vs. 36.5% ± 4.4%, t = 2.74, P < 0.05); there was no inflammatory reaction or degradation of coated particles. Conclusion DPTCPSs might have stronger initial and early fixation in a PEEK rod semi-rigid fixation system.