Objective:To explore the combined application effect of failure mode and effect analysis (FMEA) and root cause analysis (RCA) in IV infusion risk management of pediatric outpatient so as to enhance the quality of care and ensure the safety of outpatients.Methods: For this exploration, a special analysis team was established and the flowchart was drawn up, and the potential failure modes were listed by using FMEA. And the RCA was used to analyze and evaluate the key mode in these potential failure modes so as to find the root cause might affect the safety of IV infusion, and then the improved measures were implemented and the effects of new measurement were evaluated. Results:After implemented the improved measures, the risk of top 4 risk priority number (RPN) in intravenous infusion flow decreased obviously. For the transfusion management, patients' satisfaction increased from 78.09% to 95.03% (P<0.05), and nurses' satisfaction increased from 83.79% to 97.80%(P<0.05).Conclusion: The combined application of FMEA and RCA in the IV infusion risk management of pediatric outpatient can effectively reduce the occurrence of risk events, reduce nursing complaints and disputes, and enhance the quality of nursing care.

0.05). Conclusion:Ti-29Nb-13Ta-4.6Zr alloy is histocompatible.

Background and purpose:There is growing evidence that metformin,a commonly used drug in the treatment of type Ⅱ diabetes,may impede the growth of human tumors.However in a recent study it was found that metformin treatment might result in promotion of the angiogenic phenotype and increase tumorigenic progression.In this study we investigated the effects of metformin on the migration and invasion abilities of human lung adenocarcinoma cell line A549 in vitro and explored the possible underlying mechanisms.Methods:A549 cells were treated with 0.5,2 and 8 mmol/L metformin for 72 hrs.The laterad-migration and invasion abilities of the cells in vitro were measured by scratch assay and Boyden-Chamber assay,respectively.Expressions of MMP2 and MMP9 mRNA of the cells before and after metformin treatment were measured by Real-time PCR.Results:The migration rate of A549 cells was increased after treated by metformin at the concentration of 8 mmol/L.The invasion ability was also signifi cantly increased by 8 mmol/L metformin treatment from 37.4?4.6 to 59.8?7.2(P

Objective To evaluate how well the risk factors associated with stroke recurrence been controlled by community-based medical centers in urban areas of Beijing.Methods A cross-sectional study was performed in 5 community-based medical centers in urban areas of Beijing.A total of 999 patients with the experience of ischemic stroke were evaluated from Dec.2004 to Nov.2005.Results Ninety-six percent of patients suffered from at least one of the most common diseases(risk factors) associated with stroke recurrence,i.e.hypertension(HT),heart disease,diabetes,hyperlipidemia and obesity,and 80% of patients were with more than 1 disease.The proportion of HT was 79.1%(790/999) and the awareness,treatment and control rates of HT patients were 93.3%(737/790),84.3%(666/790) and 40.3%(318/790),respectively.The proportion of heart diseases and obesity among 999 stroke patients were 34.4% and 19.1%%,respectively.31.9%(319/999) of patients had diabetes and 84.0%(268/319) of the patients knew their history of diabetes.Of 319 diabetes patients,68.3%(218/319) were under active treatment and 45.4%(99/218) of them had their fasting blood glucose well controlled.The proportion of hyperlipidemia was 72.9% and the treatment rate for hyperlipidemia was as low as 29.5%(215/728).There were 43.7% and 50.0% of patients quit smoking and alcohol drinking after their acute stroke.72.7%(726/999) of patients were receiving aspirin regularly.Conclusion The proportion of cardiovascular diseases were high among the patients with ischemic stroke who were under the management of community-based medical centers.The community-based medical centers have played an important role in the secondary prevention of stroke.However,the management for ischemic stroke patients with diabetes and hyperlipidemia needs to be improved.

Objective To evaluate the clinical application of a novel hepatitis B virus YMDD mutation DNA diagnostic kit (magnetic beads method kit).Methods A total of 324 HBV clinical serum samples was tested with the magnetic beads method kit and another kind of fluorescence diagnostic kit (boiling method).Accuracy, specificity, and sensitivity were compared.Results The consistency of positive detection rate of two kits was 100％ (95％ CI : 98.0％ ～ 100％), negative consistency was 97.12％ (95％ CI : 92.8％ ～99.2％) and the total consistency was 98.76％ (95％ CI : 96.9％ ～99.7％).Four cases of discrepant samples were confirmed by sequencing, and statistical analysis performed by Kappa test (Kappa =0.975) shows good consistency between the two methods.Conclusions The magnetic beads method kit has good consistency compared to the regular boiling method kit, and the polymerase chain reaction (PCR) detection system contains an internal positive control (internal control) to avoid a false negative resuit, which is more suitable for clinical diagnosis.

[ ABSTRACT] AIM: To investigate the role of TNF-αand NF-κB in the mechanism of neuropathic pain due to chronically compressed dorsal root ganglion ( CCD) .METHODS:Based on the CCD model, von Frey filaments were used to quantify behavior test.The expression changes of TNF-αand NF-κB were determined by Western blotting, and the cor-relation between the expression of TNF-αand the 50%paw withdrawal threshold was also analyzed.Moreover, the location of TNF-αin dorsal root ganglion ( DRG) was observed with immunofluorescence double staining.RESULTS: We found 50%paw withdrawal threshold of CCD decreased at the first day after operation.The mechanical allodynia was the most ob-vious at postoperative 7~14 d and lasted longer than 35 d.The expression of TNF-αand NF-κB increased significantly in DRG after operation (P<0.01), especially at 7~14 d, and then restored gradually.Moreover, there was a correlation between the protein expression of TNF-αand the changes of neuropathic behavior ( P<0.05 ) .CONCLUSION: TNF-αand NF-κB are involved in the mechanism of mechanical allodynia after chronically compressed DRG.

Objective To investigate the clinical features, treatments and prognostic factors of rhabdomyosarcoma (RMS) in the female genital tract. Methods A retrospective analysis was performed on 13 cases of RMS in the female genital tract. Clinical characteristics, treatments and prognosis were compared and analyzed statistically. Results The median age was 21.0 years (range, 6 to 54 years). There were 6 cases vaginal RMS and 7 cases cervical RMS, included 11 cases of embryonal RMS (ERMS) and 2 cases of alveolar RMS (ARMS). According to the Federation International of Gynecology and Obstetrics (FIGO)staging system,there were 6 cases of stageⅠ, 3 cases of stageⅡ, 1 case of stageⅢand 3 cases of stage Ⅳ, the median survival time were respectively 112.5, 153.0, 9.0 and 3.5 months. According to the Intergroup Rhabdomyosarcom Study Group (IRSG) staging system, there were 10 cases of stageⅠ and 3 cases of the stage Ⅳ, and their median survival time were respectively 112.5 and 3.5 months. Nine patients received surgery and the median survival time was 108.0 months (range, 9 to 228 months), 6 of them received chemotherapy after surgery and the median survival time was 152.0 months (range, 9 to 228 months), the other 3 cases did not receive any therapy after surgery and the median survival time was 25.0 months (range, 9 to 108 months). Four patients did not receive surgery and the median survival time was 6.3 months (range, 1 to 117 months). There were 2 cases received combined treatment included radiotherapy and the survival time were respectively 4 and 198 months. There were 8 cases who was survival without disease and 5 cases died of cancer. The median survival time in 13 patients was 25.0 months (range, 1 to 228 months) and the 5-year overall survival rate was 58.6%. Conclusions The prognosis of early stage of RMS in the female genital tract is good. While, the prognosis of advanced stage is poor. The standard treatment strategy is combination of surgery and chemotherapy,whether radiotherapy could improve the prognosis still need further study.

Objective To investigate nursing interns’knowledge and attitude towards needle stick injury before clinical practice.Methods In 20-23 June,2015,nursing interns who were about to start clinical practice in a hospi-tal were investigated,nursing interns’knowledge and attitude towards needle stick injury were surveyed through questionnaire.Results A total of 350 questionnaires were distributed,324 (92.57%)responded questionnaires were available.40(12.35%)questionnaires were responded by male interns,and 284(87.65%)were by female in-terns;34(10.49%)interns had bachelor degree;the mean age of interns were (20.83 + 1 .24)years old.The correct answer rates about questions related to injury occurring during needle recapping and wearing gloves were low (about 60%).About 70% of the interns gave the correct answers to questions about hepatitis B infection due to needle stick injury following hepatitis B vaccination,as well as medication after injury.Score for individual question about attitude towards needle stick injury was ≤3,the major related problems were susceptibility of blood borne diseases and recapping needles.Conclusion Needle stick injury-related knowledge and attitude among nursing interns is inadequate,including recapping needles,timely report,susceptible to infectious diseases,and so on.It is necessary for schools and teaching hospitals to strengthen the education about occupational protection among nursing interns, so as to improve the attitude and ability of professional protection.

Objective To investigate the therapeutic effect of total mesorectal excision(TME) for low rectal cancer.Methods One hundred nineteen patients with rectal cancer,located on an average within 8 cm of the anal verge,were included in the study.Fifty-four patients underwent traditional operation,and sixty-five patients underwent total mesorectal excision.Operation time,loss of blood at operation and local recurrence rates were compared between the two groups.Results The average operation time and blood loss were 118 minutes,and 100mL respectively in TME group,and they were 182 minutes,and 340 ml respectively in traditional operation group.There were significant differences between them(all P0.05).Conclusions In TME group,operation time was shorter,operative blood loss was less,and local recurrence rate was lower.TME should be applicated for patients with low rectal cancer.

Objective To discuss the effect and advantage of the navigation-assisted system in total knee arthroplasty (TKA) of the knees with anatomical abnormality. Methods The study involved five patients with anatomical abnormality of the knees who were treated with arthroplasty under the navigation-assisted system from December 2007 to October 2008. Meanwhile, five patients with normal anatomy of the knees treated with total knee arthroplasty without using the navigation-assisted system were used as control. The α, β, γand δ angles were measured based on the X-ray images and the active range of the knee joint was determined. Results No complication caused by navigation occurred. There was no significant difference in the α, β, γ and δ angles between the two groups, but the range of extremum in the navigation group was less than that of the control group. The mean postoperative active range of the knee joint in the navigation group ( 112.67°) was higher than that of the control group ( 106.98° ), while the preoperative active range of the knee joint of the navigation group [(70.87 ± 10.87)°] was significantly lower than that of the control group [( 105.08 ± 30.67)°]. Conclusions Compared with conventional methods, navigation-assisted TKA showas no obvious advantage in short-term outcome but has great advantages in improving the accuracy and the joint movement, especially for the knees with anatomical abnormality.