Objective The care requirements and the waiting time of infusion outpatients in emergency department were evaluated to innovate the mode of outpatient and emergency infusion management. Methods 400 infusion outpatients were randomly assessed with the care requirements assessment form which were designed by ourselves. Results The accurate, timely medication treatment and care, a quiet, comfortable environment and the sharply puncture technique were wanted by most outpatients. Conclusions Information management mode-wireless mobile outpatient infusion management system, provides a technologically advanced, safe, reliable, practical solutions for emergency fluid management.

Objective To investigate the effect of EDTA combined with ciprofloxacin on Pseudomonas aeruginose biofilm in vivo.Methods Pseudomonas aeruginosa was inhaled into the lung of guinea pigs and colonized,formed biofilm.After 7 days,the model was treated with ciprofloxacin,EDTA alone,or a combination of both for 7 days.The number of colony in the lungs is measured by agar plate.The pathological change of the lung is observed by hematoxylin and eosin (HE) staining and scanning electron microscope.Results EDTA combined with ciprofloxacin make the number of bacteria in the lungs reduced from l05 CFU/g to 10 CFU/g(t =24.67,P＜0.05),the lung lesion was less-sever histophathologically.Conclusion The combination of EDTA with ciprofloxacin has significant activity to remove mucoid PA biofilm in vivo.

In order to provide a reference and theoretical guidance of the evaluation of electronic medical record (EMR) and establishment of evaluation system in China, we applied a bibliometric analysis to assess the application of methodologies used at home and abroad, as well as to summarize the advantages and disadvantages of them. We systematically searched international medical databases of Ovid-MEDLINE, EBSCOhost, EI, EMBASE, PubMed, IEEE, and China's medical databases of CBM and CNKI between Jan. 1997 and Dec. 2012. We also reviewed the reference lists of articles for relevant articles. We selected some qualified papers according to the pre-established inclusion and exclusion criteria, and did information extraction and analysis to the papers. Eventually, 1 736 papers were obtained from online database and other 16 articles from manual retrieval. Thirty-five articles met the inclusion and exclusion criteria and were retrieved and assessed. In the evaluation of EMR, US counted for 54.28% in the leading place, and Canada and Japan stood side by side and ranked second with 8.58%, respectively. For the application of evaluation methodology, Information System Success Model, Technology Acceptance Model (TAM), Innovation Diffusion Model and Cost-Benefit Access Model were widely applied with 25%, 20%, 12.5% and 10%, respectively. In this paper, we summarize our study on the application of methodologies of EMR evaluation, which can provide a reference to EMR evaluation in China.
Bibliometrics ; China ; Databases, Factual ; Electronic Health Records ; Information Storage and Retrieval

Objective To investigate the risk factors associated with cranial nerve impairment in patients with tuberculous meningitis.Methods A total of 121 patients with tuberculous meningitis who were admitted to Huashan Hospital from 2000 to 2011 were reviewed retrospectively.Demographic data (gender,age),course of disease,initial results of cerebral spinal fluid (CSF) tests,occurrence of cranial nerve impairment and prognosis of these patients were collected.All the patients were followed up for at least 3 months,and for those with cranial nerve impairment,the minimum follow-up period was 1 year in order to judge the recovery of cranial nerve impairment.Multivariate analysis was performed to study the associated risk factors.Results Out of 121 patients,22 (18.2 ％)developed cranial nerve impairment.Nerves involved were abducens nerve,oculomotor nerve,optic nerve and auditory nerve,and impairment of single nerve occurred in 9 (40.9 ％),8 (36.4 ％),7(31.8％) and 1(4.5％) patient,respectively.Three cases had more than one group of cranial nerves involved,accounting for 13.6％ of the 22 patients with cranial nerve impairment.The incidence of conscious disturbance was significantly higher in patients with cranial nerve impairment than those without impairment (77 ％ vs 45 ％,P=0.020).Delay in diagnosis (OR =1.017,95 ％ CI:1.001-1.033,P=0.040) and occurrence of conscious disturbance (OR =3.242,95 ％ CI:1.142-9.205,P=0.027) were independent predictive factors of cranial nerve injury.During one-year follow-up,90.9％ of patients were fully recovered from cranial nerve impairment,with a median duration of 1 month (range 0.5-6.0 months).Conclusions Cranial nerve impairment is a common complication in patients with tuberculous meningitis.Delay in diagnosis and occurrence of conscious disturbance were independent predictive factors.Most cranial nerve impairment were reversible,and timely diagnosis and treatment are important ways to reduce complications.

BACKGROUND:Al oying is a convenient and effective method to alter the microstructure and control the corrosion behavior of magnesium al oy.
OBJECTIVE:To explore the in vitro and in vivo degradation of Mg-Nd-Zn-Zr al oy as a degradable medical biomaterial.
METHODS:(1) In vitro static immersion test:The immersion tests were carried out at (37.0±0.5) thermostatic bath. Six Mg-Nd-Zn-Zr al oy samples and six pure magnesium samples were immersed in the 250 mL simulated body fluid and vibrated without agitation during immersion. After 3, 7 and 30 days static immersion, the samples were taken out from the simulated body fluid. Then the in vitro corrosion properties were evaluated using scanning electron microscope and energy dispersive spectrometer analysis. (2) In vivo animal experiment:After bone tunnel was established in the left femur of adult New Zealand rabbits, the Mg-Nd-Zn-Zr al oy rods were embedded in the Mg-Nd-Zn-Zr al oy group, titanium al oy rods were embedded in the titanium al oy group, and only bone tunnel was established in the sham-operated group. At 1, 2, 4, 8 weeks after implantation, an X-ray of the implanted region was taken to determine the location and the degradation behavior℃in a of Mg-Nd-Zn-Zr al oy. At 4, 8 weeks after implantation, the corrosion product and its element composition were observed using scanning electron microscope with an energy dispersive spectroscopy system.

Aim To establish a hepatic carcinoma cell line with stable voltage-gated chloride channel 3 ( ClC-3 ) gene silencing through the lentivirus-mediated short-hairpin RNA ( shRNA ) method and investigate the effects of gene silencing on invasion and migration. Methods Three lentiviral vectors coding shRNA tar-geting ClC-3 gene were constructed, the recombinant plasmids were packaged into mature lentivirus by 293FT cells, and then the lentiviruses were harvested, concentrated and titrated. MHCC97H cells were infec-ted with the recombinant lentiviruses and then were se-lected to obtain cell lines stably expressing ClC-3 shR-NA. The efficiency of ClC-3 mRNA and protein ex-pression interference were determined by real-time flu-orescence quantitative PCR and Western blot, respec-tively. The effects of ClC-3 gene interference on inva-sion and migration of MHCC97 H cells were performed by Transwell chamber assays with or without Matrigel and cell scratch assay. Results The recombinant lentiviral vectors were successfully constructed and four lentiviruses were acquired after packaged by 293 FT cells. One negative control cell line and three cell lines with ClC-3 gene interference ( MHCC97 H/shClC-3-1 , shClC-3-2 and shClC-3-3 ) were successfully construc-ted after MHCC97 H cells were infected with lentivirus-es. The expression level of ClC-3 mRNA and protein in three ClC-3-silenced cells were obviously lower than the negative control cells ( P <0. 01 ) , MHCC97 H/shClC-3-2 cells showed the greatest inhibition of ClC-3 mRNA and protein expressions. As compared with the negative control cells, the ClC-3 gene interference sig-nificantly decreased invasion and migration of MH-CC97 H cells in vitro ( P <0. 01 ) . Conclusion The hepatic carcinoma cell lines with stable ClC-3 gene si-lencing were successfully established and the ClC-3 gene interference could significantly inhibit invasion and migration of MHCC97H cells.

Objective To understand the epidemiology and clinical features of avian influenza,improve the prophylaxis and treatment.Methods Clinical data of a fatal case caused by H7N9 avian influenza A virus in Shanghai was retrospectively reported and analyzed,literature on avian influenza A virus infection in human was reviewed.Results A severe case of H7N9 avian influenza was reported,with typical clinical characteristics.The epidemiology history of the patient was unclear,all the contacts were tested negative for H7N9 avian influenza A virus.Literature search,H7 subtype of avian influenza in 2012 was only sporadic,the majority of patients with mild symptoms.People did not have immunity against avian influenza.Conclusions Severe case of H7N9 avian influenza progress quickly and its infection pattern is not clear up-to the time point.It needs further exploration and discovery.

Objective To identify drug resistance status of Mycobacterium tuberculosis (MTB) strains by the GenoType MTBDRplus line-probe assay (LPA),compare its performance with traditional drug susceptibility testing (DST),and to assess its predictive value for the prognosis of patients with drug resistance tuberculosis.Methods Pulmonary tuberculosis patients who visited Zhuji People's Hospital,Zhejiang Province during February 2011 and January 2012 with a positive result of sputum smear at baseline were all recruited.A total of 275 culture positive specimens were collected,then isolated and cultured for Mycobacterium tuberculosis in the laboratory.DST were performed,meanwhile,GenoType MTBDRplus were also applied to detect resistance to isoniazid (INH) and rifampin (RMP).All the tuberculosis patients who were recruited were followed,including sputum culture and chest radiography.Results There were 192 strains showing drug resistance both by DST and MTBDRplus LPA.Fourteen multidrug resistant (MDR),21 INH mono-resistant and 2 RMP mono-resistant strains were detected by DST.As for GenoType MTBDRplus LPA,MDR,INH mono-resistant and RMP mono-resistant strains were 14,18 and 2,respectively.Taken DST as the gold standard,LPA was more accurate in the detection of resistance to RMP,while it failed to detect 23.8％ (5/21) of the INH-resistant strains.We analyzed the prognosis of patients with drug resistance by GenoType MTBDRplus LPA,the rates of treatment success were 84 ％ (110/131),9/15,3/11 in patients infected with susceptible,INH mono-resistant and MDR strains,respectively.For the 2 cases of RMP mono-resistanee,one was cured and the other failed.The predictive value of molecular drug resistance test for treatment failure in INH mono-resistant patients was 40.0 ％,while that was 83.5 ％ for treatment success in INH susceptible patients.The predictive value for treatment failure in RMP mono-resistant patients was 50.0％,while that was 81.5％ for treatment success in RMP susceptible patients.The predictive value for treatment failure in MDR patients was 72.7％,while that was 81.1％ for treatment success in patients without MDR.Conclusion The GenoType MTBDRplus LPA assay is a rapid and reliable diagnostic test for resistance of MTB,which can be used to predict the prognosis of drug resistant tuberculosis in the clinical practice.

BACKGROUND:The therapeutic effects of donkey-hide glue reinforcing bone oral solution on osteoporosis have been determined, but the exact effective mechanism is to be approached. OBJECTIVE: To investigate the effects of donkey-hide glue reinforcing bone oral solution (DGRBOS) medicated serum on osteoprotegerin (OPG)and its ligand(OPGL)mRNAexpression of osteoblast in fetal rats and explore the molecular mechanism of treating osteoporosis with DGRBOS. DESIGN: A randomized controlled trial. MATERIALS: The experiment was carried out from June 2003 to October 2004 in Bone Metabolic Laboratory of Department of Integrative Chinese and Western Medicine, Affiliated Hospital of Tongji Medical College,Huazhong University of Technology and Science. Totally 30 3-month-oldWistar rats (15 males and 15 females) were randomly divided into 3 groups, I.e. DGRBOS group, estrogen group and control group, with 10 rats in every group. 12 clean newborn SD rats were selected to isolate and cul ture osteoblast. METHODS: ①After intragastric administration for 7 days, medicated serum was prepared respectively from the three groups. ②Skull osteoblast isolated from newborn SD rats was made into single cell suspension, then after digestion and passage, the subcultured osteoblast cell was made into cell suspension. The cultured osteoblasts were divided into 5 groups and given equal volumes of drug liquor. The DGRBOS group was given DGRBOS-medicated serum at the concentration of 100, 500 and 1 000 g/L which was diluted by nutrient solution; the estrogen group was given tibolone-medicated serum of 100 and 1 000 g/L; the control group was givenonly culture fluid. Meanwhile every group was given calf serum (100 g/L) for further culture. ③The osteoblast proliferation was measured by antigenic MTT colorimetric analysis and 3H-TdR penetration method. The in tra-cellular BGP contents were evaluated by radioimmunity .The mRNA expression of OPG and RANKL in osteoblast was analyzed by Rt-PCR. ④ One-way analysis of variance was applied to compare data among groups. MAIN OUTCOME MEASURES: mRNA expression of OPG and PAN KL in osteoblasts from fetal rats after intervention by medicated serum ofDGRBOS or Livial. RESULTS: ①The osteoblast proliferation measured by antigenic MTT colorimetric analysis and 3H-TdR penetration method showed that the proliferation in the DGRBOS group and tibolone group was enhanced moresignificantly than that in the control group (P ＜ 0.05-0.01), and reached maximal effect at the concentration of 500 g/L (P ＜ 0.01), but when the concentration was over 500 g/L, the effect tended to saturate. The medicated serum with all concentrations from DGRBOS and estrogen groups could increase the contents of BGP in osteoblasts (P ＜ 0.05). ②The mRNA expression of OPG reached the peak when the DGRBOS medicated serum was 1 000 g/L, and was obviously higher than that at the concentration of 100 and 500 g/L (P ＜ 0.05). The expression in DGRBOS group at the concentration of 1 000 g/L and in the estrogen group at the concentration of 100 and 1 000 g/L was apparently higher than that of the control group (P ＜ 0.01). ③The mRNAexpression of RANKL was the highest in DGR BOS group with 1 000 g/L concentration, and was markedly lower than that of the concentration of 100 and 500 g/L (P ＜ 0.05). The expression in DGRBOS group at the concentration of 1 000 g/L and in the estrogen group at the concentration of 100 and 1 000 g/L was noticeably lower than that in the control group (P ＜ 0.01).CONCLUSION: ①The DGRBOS could remarkably enhance osteoblast proliferation in dose-dependent and a dose-saturable manner, and the effect was close to that of tibolone. ②Partial mechanism of DGRBOS in treating osteoporosis might be promoting osteoblast proliferation and regulating OPG/RANKL expression.

events were associated with promestriene use. Conclusion The premestriene capsule was safe and effective in the treatment of postmenopausal atrophic vaginitis.