Teamwork impacts the effectiveness of care, patient safety and clinical outcomes, and team training has been identified as a strategy for enhancing teamwork, reducing medical errors and building a culture of safety in healthcare. The paper reviewed the concept, construct, training model, measures and implementation in healthcare of team strategies and tools to enhance performance and patient safety (TeamSTEPPS) which was the most widely applied team training strategy, in order to provide reference for the healthcare in China.

Objective The aim of this study was to investigate the understanding and application of the Chinese Urological Association (CUA) guidelines of Benign Prostatic Hyperplasia (BPH) (2011 edition) in Chinese urologists.Methods The survey was conducted between September,2012 and November,2012.Questionnaires designed by the CUA were used to investigate the understanding and management of BPH in CUA-registered urologists,who work in clinic for at least 20 hours per week.Data,including general characteristics of the urologists,understanding of BPH,BPH diagnosing in suspected patients,BPH treatment,and follow up,were collected.7500 questionnaires were distributed.A total of 4 897 participants responded (response rate 70.0％).86 questionnaires with incomplete information and 37 duplicate questionnaires were excluded.And 4 774 validate questionnaires were included for the analysis,finally.The mean age of those investigated urologists was (39.9±9.2) years old.Among them,3 802 (81.0％) urologists work in the tertiary hospital,878 (18.7％) urologists work in the secondary hospital and 12 (0.3％) urologists work in the other hospital.The district distribution in those urologists included 455 (9.6％) in northeast china,812 (17.1％) in north china,1 696 (35.6％) in east china,869 (18.2％) in south china,634 (13.3％) in southwest china,295 (6.2％) in northwest china.1 835 (43.8％) urologists have less than ten years working experience.1 505 (35.9％) urologists have 11 to 20 years working experience.The 21 to 20 years working experience was reported in 705 (16.8％) urologist.And the other 149 (3.5％) urologists have working experience more than 31 years.The educational background in this study included doctor degree in 732 (15.8％) urologists,master degree in 1 729 (37.4％) urologists,bachelor degree in 2 067 (44.7％)urologists and college degree in 101 (2.1％) urologists.The position composition included 834 (18.2) directors,1 371 (30.0％) deputy directors,1 605 (35.1％) attendings and 765 (16.7％) residents.The data were analyzed using rank-sum test,2 test,or Fisher's exact test.Results The understanding of BPH clinical progression and progression-associated risk factors in Chinese urologists was poor.Compared to the guidelines,the rate of consistent were only 43.4％ (2 023/4 665) and 10.2％ (477/4 660),respectively.The initial evaluation methods for suspected BPH patients were in low consistency with the guidelines (20.2％,845/4 181) and were inconsistent among different areas [66.5％ (290/436) in northeast china,64.7％ (556/859) in south china,55.6％ (158/284) in northwest china,55.1％ (922/1 672) in east china,54.7％ (435/795) in north china,48.0％ (296/617) in southwest china].The participants showed poor understanding of the primary goal of treatment for BPH (4.9％ consistent,229/4 666) and the criteria about watchful waiting (22.5％ consistent,1 051/4 674).However,the understanding of surgical indications for BPH was good (94.6％ consistent,4 410/4 663).The therapeutic effects of 5α-reductase inhibitor for BPH were acknowledged by 93.4％ (4 388/4 699) participants.The consistent rate with the guidelines of follow-up examinations was low for patients with watchful waiting (7.8％,355/4 531),medication treatment (8.4％,373/4432),and surgery (44.8％,2 105/4 702).Conclusions The understanding of the CUA BPH guidelines is poor in Chinese urologists.Target training in the specific urologists with tailored contents is necessary.

OBJECTIVETo compare the differences in the efficacy on depression after breast cancer operation treated with auricular point sticking therapy, the combined program of auricular point sticking therapy and TCM psychotherapy and medication with deanxit.

METHODSNinety patients were randomized into 3 groups, 30 cases in each one. In the western medication group, the simple oral administration of deanxit was applied, one tablet a day. In the auricular point group, Xin (GO15), Shen (CO10), Gan(CO12), Shenmen(TF4), Pizhixia (AT), Neifenmi (CO18) were selected and stimulated with auricular point sticking on either side in each treatment, once a week. In the combined program group, on the basis of the treatment as the auricular point group, TCM psychotherapy was combined with. The treatment of 4 weeks made one session. One session and 4 weeks follow-up were required. The self-rating depression scale (SDS) was used to compare the score before and after treatment in the patients of each group and the efficacy was assessed.

RESULTS(1) Compared with those before treatment, in 4 weeks of treatment and 4 weeks of follow-up, SDS scores were all reduced apparently in the 3 groups (all P<0.001). After 4 weeks of follow-up in the auricular point group, after 2 and 4 weeks of treatment and 4 weeks of follow-up in the combined program group, SDS scores were all lower than those in the western medication group (all P<0.05). (2) After 4 weeks of treatment, the curative rate in the combined program group was higher than that in the auricular point group and the western medication group [60.0% (18/30) vs. 40.0% (12/30), 36.7% (11/30), both P<0.05)]. After 4 weeks of follow-up, the curative rate in either the combined program group or the auricular point group was higher than that in the western medication group [60.0% (18/30), 30.0% (19/30) vs. 23.3% (7/30), both P<0.05].

CONCLUSIONThe auricular point sticking therapy, the combined program of auricular point sticking therapy and TCM psychotherapy, and medication with deanxit all relieve depression after breast cancer operation. The efficacy of the combined program with auricular point sticking therapy and TCM psychotherapy involved is the best, and the efficacy of the auricular point sticking therapy is better than the oral administration of deanxit.

Acupuncture Points ; Acupuncture, Ear ; Adult ; Aged ; Breast Neoplasms ; complications ; surgery ; Depression ; etiology ; therapy ; Female ; Humans ; Middle Aged ; Treatment Outcome

Objective To compare the outcome and early patency rate of revascularization treatment for patients with iliac artery occlusion or stenosis.Methods Retrospective analysis was made on 105 cases of iliac artery occlusion or stenosis from January 2009 to April 2014.49 were with iliac artery occlusion and 56 with iliac artery stenosis.Results The demographics,and comorbidities were not statistically different between the 2 groups.The occlusion group had more critical limb ischemia and the ankle-brachial index was lower than the stenosis group.The occlusion group underwent more hybrid surgery and used more covered stents in the operation.The peri-operative complication was higher in the occlusion group,but the difference was not statistically different.The ABI improved significantly for all patients after surgery.The early patency rate was similar in the 2 groups.Conclusions Revascularization treatment for patients with iliac artery occlusion and stenosis was safe and effective,with similar early patency rate and peri-operative complications between the two groups.

Objective To investigate the psychological situation on people who experienced after earthquake in yushu ,the rela-tives far away from the earthquake ,rescue workers ,the general population far away from the earthquake zone .From investigation to provide powerful evidence for the crisis intervention .Methods PTSD Checklist (PCL-C) ,Self-Rating Anxiety Scale(SAS) ,Self-Rating Depression Scale (SDS) ,Symptom Checklist 90(SCL-90)were used on the victims to survey different groups of people in different stages .Results The detection rate of PTSD ,anxiety ,depression about different groups of people in different stages were different ,The detection rate of PTSD ,anxiety ,depression and SCL-90 factor scores in the same crowd as the time went on showed a downward trend .The detection rate of PTSD ,anxiety ,depression and SCL-90 factor scores in different people showed a downward trend with the increase of distance from the hypocenter .Conclusion There are different degrees of psychological problems to differ-ent groups of people in different stages ,we should strengthen psychological intervention efforts to improve the ability to stress e-vents .

OBJECTIVETo discuss the effect of continuous positive airway pressure (CPAP) treatment for functional cardiac arrhythmias combined with obstructive sleep apnea hypopnea syndrome.

METHODSFifty-six OSAHS patients combined functional cardiac arrhythmia were randomized divided into two groups. The 28 patients in the control group were treated with metoprolol according to cardiac guidelines, the other 28 cases in the experimental group were treated with CPAP therapy combined with metoprolol. AHI and the lowest oxygen saturation (LSaO2) were tested before and after treatment.

RESULTSThe efficiency rates were 57.1% and 17.9% in experimental and control group respectively, with statistical difference (χ2 = 7.62, P < 0.01). Total effective rates were 85.7% and 53.6% respectively, with statistical difference (χ2 = 5.41, P < 0.05). In the experimental group, there were three treatment subgroups. After treatment, AHI and the lowest oxygen saturation were significantly different (P < 0.05).

CONCLUSIONCPAP treatment can effectively eliminate respiratory disturbance index, improve the symptoms of hypooxygen at night, and effectively improve the therapeutic effect of functional cardiac arrhythmias in OSAHS patients combined with functional arrhythmia.

Arrhythmias, Cardiac ; therapy ; Brugada Syndrome ; Cardiac Conduction System Disease ; Continuous Positive Airway Pressure ; Heart Conduction System ; abnormalities ; Humans ; Sleep Apnea, Obstructive ; therapy

AIM: Centrifuge training can improve forward acceleration (+Gz) endurance. This study was to analyzed the gene expression of rat heart affected by centrifuge, and to research the molecular mechanism of improving +Gz endurance by centrifuge training. METHODS: Differential expressed genes between high+Gz endurance (+16Gz) rats, of test group after trained 12 d and control were screened using suppression subtractive hybridization (SSH) and dot blot hybridization. The obtained expressed sequence tags (ESTs)were used as probes to perform RNA slot hybridization with heart total RNA isolated from each gruop of centrifuge training and high+Gz endurance and low+Gz endurance (+12Gz) rats, respectively. The positive ESTs were sequenced and analyzed using BLAST(nr) at NCBI.RESULTS: Three down-regulated ESTs were obtained from heart samples, all of them are new, and their expression levels were decreasing during centrifuge training. CONCLUSION: Centrifuge training can significantly affect the special gene expressions of rat heart, and the expression changes of these genes may be ralated to the mechainism that +Gz endurance can be improved by centrifuge training.

The clinical data of 21 patients with carotid body tumor (CBT) were analyzed retrospectively.The lesions were unilateral (n =20) and bilateral (n =1).Among 20 surgical cases, the procedures included tumor resection alone (n =11) , tumor resection along with external carotid artery (n =6) and vascular reconstruction of carotid artery after resection of tumor body (n =3).No mortality occurred during perioperative period.CBT was confirmed by pathologic examination in all cases and 1 case was malignant.Follow-up period ranged from 3 months to 7 years and the follow-up rate was 85％.Five cases of cranial nerve impairment recovered completely over 3 months.One case of bilateral CBT underwent contralateral tumor resection at another hospital 1 year later and 1 case with malignant tumor died from metastases 3 years later.The remainder survived recurrence-free.CBT tends to be misdiagnosed.Therefore ultrasonography, digital subtraction angiography (DSA), CT angiography (CTA) or magnetic resonance angiography (MRA) are important for preoperative diagnosis and evaluation.Surgical resection is a first choice for CBT.

Objective To evaluate carotid endarterectomy (CEA) for bilateral moderate to severe carotid stenosis.Methods The clinical data of 59 patients with bilateral moderate to severe carotid stenosis who were treated with CEA in our hospital from October 2010 to August 2014 were retrospectively analyzed.There were 50 males and 9 females age ranging 42-80 years (mean:65 ± 9 years).48 patientsunderwent ipsilateral CEA and 11 underwent staged bilateral CEA.In patients who were confirmed to have coronary artery disease or peripheral vascular disease by preoperative angiography,6 received coronary artery bypass graft (CABG)simultaneously,1 received iliac artery balloon angioplasty and stent implantation simultaneously,and 1 received renal artery stenting simultaneously.Results A total of 70 endarterectomies were performed,shunt and patching were used in all patients,the surgical success rate was 100％.2 patients suffered from vagus nerve injury,4 patients suffered from hypoglossal nerve injury,and 3 patients presented with hyperperfusion syndrome.Follow-up period was 2-36 months (mean:19 ± 10 months).1 patient died of heart attack during the follow-up,the other patients were relatively stable with no restenosis.Conclusion CEA should be performed in patients with bilateral moderate to severe carotid stenosis,and the prognosis is good.

Objective To design and investigate the clinical effects of parallel double venous pots hemodialysis tubing set in patients with heparin-free hemodialysis.Methods Totally 120 patients who received hemodialysis therapy in our hospital from May,2014 to June,2016 were randomly divided into the experimental group (n=60) and the control group(n=60) via random number table.The experimental group received self-designed parallel double venous pots dialysis tubing set,while the control group received the normal dialysis tubing set.The number of preventive replacement of dialyzer and tubing set during heparin-free dialysis,the number of discarded tubing set due to coagulation and the time frame for the first tubing set were recoded from two groups.Results There were statistically significant differences in the number of discarded tubing set due to coagulation and the time frame for the first tubing between two groups(P＜0.05).Conclusion Parallel double venous pots dialysis tubing set can reduce the number of discarded tubing set due to coagulation,prolong the time frame for the first tubing.