Objective To investigate the effect of continuous quality improvement on venous transfusion exosmosis in elderly patients.Methods Through the investigation into venous transfusion exosmosis in 160 elderly patients,the causes for exosmosis were identified,followed by regulating and enforcing improvement measures and assessing the effect.Results The incidence of venous transfusion exosmosis in elderly patients was reduced from 6.40%to 2.57%and the satisfaction of patients improved from 90.00%to 97.50%.Conclusion The continuous quality improvement may effectively reduce the incidence of venous transfusion exosmosis and improve patients’satisfaction.

Background Corneal confocal microscopy can denamically offer the morphological image of corneal cells at cellular level.To find out the dynamic change of corneal thickness and morphology of corneal cells with aging is very important for the design of corneal refractive surgery.ObjectivePresent study is to find out the important relevance of dynamic change of corneal thickness and morphology of corneal cells with aging and the design of corneal refractive surgery and investigate the influence of age on central corneal tissue and characterize precisely the anatomy of cornea by in vivo confocal microscopy.Methods122 eyes of 122 normal subjects were enrolled in this study with the age from 18 through 80 years old.The subjects were diagnosed as emmetropia in the Center of Tianjin Medical University from August 2003 to December 2007.All eyes were examined in vivo by confocal microscopy.The cell morphology,cell density and corneal thickness were measured by confocal microscopy.The relationship of central corneal tissue change and age was evaluated.ResultsThe density of corneal superficial basement epithelial cells showed a significantly negative correlation with age (r=-0.355,P=0.017).The keratocyte density in the anterior and posterior stroma indicated a significantly negative correlation with age (r_1=-0.462,P=0.001;r_2=-0.403,P=0.016).The thickness of corneal epithelium cells had a significantly negative correlation with age (P=0.02).The mean value of total corneal thickness and stromal thickness in high myopic eyes was (523.2±26.20)μm and (468.4±20.72)μm respectively,presenting a significantly negative correlation with age (r_1=-0.552,P=0.014;r_2=-0.545,P=0.035).A significantly negative correlation was also found in endothelial cell areas and density with age (r_1=0.417,P=0.004;r_2=-0.598,P=0.002).The percentage of polymorphological corneal endothelial cells was considerably increased(r=0.417,P=0.004)but that of pleomorphism cells was significantly decreased in >60-year-old population compared with younger subjects (r=-0.598,P=0.002).The morphology of corneal basement cell,anterior stroma cytocyte and endothelial cell were normal in younger subjects,and enlargement of the cells in size,decreases of number and density of the cells were found in >60-year-old subject.ConclusionThe anatomy and histology of the central cornea in young subjects exist discrepancy from older ones.The corneal hisological changes with aging include thinner thickness of epithelium,thinner thickness of cornea,decreased density of keratocyte and endothelial cells and increased size of endothelial cells.Corneal thickness is asymmetric and seems to undergo age-related anatomic changes.

Objective To construct and screen siRNA targeting a proliferation-inducing ligand (APRIL) gene in a mouse colorectal cancer celline, CT-26. To investigate the effects to the cell growth and migrant capacity of CT-26 after knockdown APRIL gene, lay the foundation for molecular targeted therapy to colorectal cancer. Methods Four pairs of APRIL siRNA were designed and chemically synthesized. And disorder sequences were synthesized as a negative control. These sequences were transfected with LipofectAMINE 2000 into CT-26 cells, which high-expressed APRIL gene. The transfection efficency rate of 6-FAM labelled control siRNA was detected by fluorescence microscope. The inhibition effectiveness of APRIL mRNA and protein was analyzed by FQ-RT-PCR and Western blot, respectively. Cell proliferation activity was analyzed by cell counting kit-8, cell migration capacity was detected by the repair of cell damage, and MMP-2 together with TIMP-1, two important regulatory genes in cell metastasis, were measured by RT-PCR.Results The different kinds of APRIL siRNA effectively suppressed the level of APRIL mRNA and the protein expression in CT-26 (P ＜ 0.05 ). Cell proliferation and metastasis ability were repressed after APRIL siRNA transfection( P ＜ 0.05 ), compared with random siRNA control and nontransfected control. The mRNA levels of MMP-2 and TIMP-1 genes wre significantly altered among APRIL siRNA groups and two control groups ( P ＜ 0.05). Conclusion We have constructed and screened a kind of siRNA (APsi737) targeting APRIL gene in a mouse colorectal cancer cell line, CT-26. APRIL siRNA can effectively inhibit the cell growth and migration capacity, maybe be regulated by MMP-2 and TIMP-1.

Objective To observe the clinical efficacy of fire-needle acupuncture in treating chronic cough after a cold. Method Totally 120 eligible subjects with chronic cough after a cold were randomized into two groups: 60 cases in the treatment group were intervened by acupuncture with fire-needles, while the other 60 cases in the control group were by acupuncture with ordinary filiform needles plus cupping. Result The recovery rate was 85.0% in the treatment group versus 65.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Fire-needle acupuncture can produce a significant efficacy in treating chronic cough after a cold, and it has a rapid onset of action, lower cost, and it’s easy-to-operate.

Objective To study the dose-effect relationship and time-effect relationship of T cell receptor (TCR) gene mutation induced by γ-rays in lymphocytes of human peripheral blood.Methods Samples of peripheral blood were collected from 10 healthy adults and lymphocytes were separated.Four samples from males used to fit time-effect curve were exposed to γ-rays at the doses of 0,0.5,1.0,1.5,2.0,2.5,3.0,3.5,4.0,and 5.0 Gy,respectively,and 6 samples from 3 males and 3 females used to fit dose-effect curves were exposed to γ-rays of the dose of 2 Gy.Flow cytometry was used to detect the mutation frequency of TCR gene (TCR MF).Radiation dose-effect curves and time-effect curves were fitted and optimal mathematical models were selected respectively.Results The optimal mathematical model for radiation dose-effect was quadratic equation model:TCR MF = 92.14 + 22.61D2 (R2adj = 0.65).The optimal mathematical model for radiation time-effect was quadratic polynomial equation model:TCR MF = 3.74 + 743.66T + 308.64T2 (R2adj = 0.79).Conclusions TCR MF is increased as the γ-rayirradiation dose increases within the range of 0-5 Gy,and TCR MF is increased with the lapse of time within the range of 4 days after γ-ray radiation.

Objective:To investigate the status quo of a mobile nursing application acceptance of nurses, and analyze the influencing factors, so as to promote the application of a mobile nursing APP in clinic.Methods:On the principle of convenience sampling, 1207 participants from Shandong province were recruited to complete the self-designed questionnaire, including demographic data, smartphone use behavior and acceptance evaluation of the mobile nursing APP.Results:Average score of nurses' acceptance of a mobile nursing APP was 4.16±0.69. Multiple regression results showed that duty, use experience, recognition, smartphone self-efficacy and daily use time were the main factors affecting the acceptance of a mobile nursing APP for nurses ( t value was -7.132-22.678, P<0.05 or 0.01) and explained 39.1% of the total variation of the acceptance of mobile nursing app ( P<0.01). Conclusions:The acceptability of mobile nursing APP of clinical nurses is at a medium and high level, and it is influenced by the use experience, smartphone self-efficacy and other aspects, suggesting that nursing managers attach importance to the behavioral differences of nurses in using a mobile nursing APP.

OBJECTIVE:To establish quality standard of Fushiming capsule. METHODS:TLC was used to qualitatively identify the ligustilide,aurantio obtusin,chrysophanol,fruit of Chinese wolfberry and Whitmania pigra,respectively. HPLC method was used to determine the contents of puerarin and ginsenosides Rb1. The determination was performed on Intersil C18 column with mobile phase consisted of acetonitrile-0.3% phosphoric acid(gradient elution)at flow rate of 1.0 mL/min;the detection wavlength was set at 203 nm,and column temperature was 25 ℃;the sample size was 10 μL. RESULTS:TLC spots of ligustilide,aurantio obtusin,chrysophanol,the fruit of C. wolfberry and W. pigra were clear and well separated without negative interference. The linear range of puerarin and ginsenoside Rb1were 10.56-337.92 μg/mL(r=0.999 7)and 17.80-569.70 μg/mL(r=0.999 6). The limits of quantitation were 2.20,1.86 μg/mL,and the limits of detection were 0.12,0.13 μg/mL,respectively. RSDs of precision,stability and reproducibility tests were lower than 2.0%. The recoveries were 95.65%-99.66%(RSD=1.45%,n=6) and 96.95%-98.52%(RSD=0.77%,n=6),respectively. CONCLUSIONS:Established quality standard can be used for the quality control of Fushiming capsule.

Basic Requirements of Teaching Basic Courses of Computer in Universities proposed pro-moting reforms to universities' computer basic education, whose core was to cultivate the students' computational thinking ability, infiltrating the essential thinking method of computational science in content and design of the course. Tianjin Medical University distinguished different levels of students according to a proficiency test, implemented graded teaching, introduced MATLAB in the course of program design, and performed modular teaching according to the students' specialties. All courses implemented small class teaching to strengthen the students' ability to apply computational thinking and computer technology to medical practice and introduced network-based test, in order to provide ideas for the teaching reform of computer basic courses in medical col-leges and universities.

Objective:To understand the current situation and demand of intracavity electrocardiographic positioning technique training for PICC specialist nurses in Shandong Province, and provide a reference for further improving and improving the training of PICC specialist nurses.Methods:From July 7-23, 2019, a total of 903 PICC specialist nurses in Shandong Province were selected by the convenience sampling method. The nurses were investigated by the self-made general information questionnaire of PICC specialist nurses in Shandong Province and the training demand questionnaire of intracavity electrocardiographic positioning technique.Results:40.75% (368/903) PICC specialist nurses had participated in intracavity electrocardiographic positioning technique training; 84.27% (761/903) PICC specialist nurses thought it necessary to conduct intracavity electrocardiographic positioning technique training. PICC specialist nurses had various training on intracavity electrocardiographic positioning technique, the average content requirements were all above 4.67 points. The highest score of theoretical training content was the judgment of the relationship between catheter tip position and electrocardiogram P wave (4.80 ± 0.47), and the highest score of operation training content was the intracavitary electrocardiography guided PICC catheterization (4.74 ± 0.55). 94.24%(851/903) PICC specialist nurses hoped to achieve the goal of improving clinical nursing practice ability through intracavity electrocardiographic positioning technique training. Intravenous therapy specialist academic conference was the main hoped training form(76.85%, 694/903). Multiple regression analysis showed that the number of years of catheterization, job position and understanding of the technology were the influencing factors of PICC specialist nurses′ training needs for intracavity electrocardiographic positioning technique ( t = -3.73,3.12, -3.63, all P<0.05). Conclusions:The training rate of intracavity electrocardiographic positioning technique was low, but PICC specialist nurses had higher training requirements for intracavity electrocardiographic positioning technique. Managers should pay attention to the training of intracavity electrocardiographic positioning technique, and develop targeted training programs to further improve the clinical practice capabilities of the PICC specialist nursing team.

Background and objective Mediastinal lymphoma or right upper lung cancer is a common cause of superior vena cava obstruction syndrome (SVCOS). Endobronchial ultrasound-guided needle aspiration (EBUS-TBNA) biopsy is applied for the diagnosis of mediastinal mass disease. hTe aim of this study is to explore the safety and feasibility of EBUS-TBNA biopsy under general anesthesia for the clinical diagnosis of SVCOS. Methods Twenty-ifve cases of SVCOS re-ceived EBUS-TBNA under general anesthesia between June 2012 and June 2013. hTe group consisted of 16 male and 9 female patients aged 33 years to 76 years, with a median age of 62.5. Results Twenty-four cases were conifrmed to be of malignant pathology, and one case failed to yield a clear pathological diagnosis. No patient experienced any complications related to the operation, such as heavy bleeding and pneumothorax. Conclusion For patients presenting with SVCOS, EBUS-TBNA under general anesthesia is a safe and reliable inspection method of high diagnostic yield. hTis method can be used for routine exami-nation when other means cannot obtain clear pathological diagnosis.