A near infrared spectroscopy ( NIRS) method was used for rapid quality evaluation of ferulic acid content in chrysanthemum morifolium cv. ( Chuju) continuous cropping soil. Standard leverage, studentized residual and Mahalanobis distance were calculated to eliminate abnormal samples. After the initial near infrared spectrum was treated by two second derivative and Norris smoothing filter noise, 6000-4000 cm-1 wave number range and 7 factors were chosen for partial least squares ( PLS) calibration model. The results showed that good correlation was presented between the calibration set/validation set and the values determined by high performance liquid chromatography, and the calibration correlation coefficient ( Rc ) and validation correlation coefficient ( Rcv ) were 0. 9914 and 0. 9935, respectively. Root mean square error of calibration (RMSEC), root mean square error of validation (RMSEP) and root mean square error of cross-validation (RMSECV) were 0. 484, 0. 539 and 0. 615, respectively. This method was accurate, reliable, simple, rapid and nondestructive, and could be applied to the fast analysis for ferulic acid in continuous cropping soil.

Objective To evaluate hepatic functional reserve and operational risks of primary hepatic carcinoma in Child A using functional CT.Methods In 128 cases of primary hepatic carcinoma of Child A undergoing hepatoectomy and identified by pathology, CT perfusion scanning and measurement of remannent hepatic volume were done before operation and whole patients were divided in-to acute hepatic failure group(AHF group,33 cases)and non-acute hepatic failure(non-AHF group,95 cases).All variables were ana-lyzed by one way analysis of variance(one-way ANOVA)firstly.The variables with significance (P<0.05)were analyzed with Step-wise Logistic regression further.Results One-way ANOVA result:There were significant difference between two groups in RHVS measured by CT,PVP,HBF,HBV,serum creatinine,thrombinogen activity,total bilirubin and intraoperative blood loss (P<0.05).The StepwiseLogistic regression analysis demonstrated that decreased RHVS and the lowed PVP were the independent risk factors of AHF complicated to hepatoectomy of primary hepatic carcinoma(P<0.01).Conclusion Hepatic functional reserve and operational risks of primary hepatic carcinoma could be j udged with functional CT before operation .

Objective To investigate the risk factors of bloodstream infection-related death after liver transplantation.Methods The retrospective case-control study was adopted.The clinical data of the 107 patients with bloodstream infection from 365 liver transplantation patients who were admitted to the Third Xiangya Hospital of Central South University (220 patients) and South Central Hospital Affiliated to Wuhan University (145 patients) from January 1,2002 to December 31,2015 were collected.The patients received modified piggyback liver transplantation.The second or third generation celphalosporin or carbapenems antibiotics were preventively used against infection according to the bacterial culture results before surgery,and the immune inhibitor basic program after surgery was FK506 + prednisone.The observation indicators included:(1) the bloodstream infection status after liver transplantation:incidence of bloodstream infection,frequency of bloodstream infection,inadequate antiinfection treatment,primary infection position,microorganism infection type,bacterial culture results and bloodstream infection-related mortality.(2) The risk factors of blood stream infection-related death after liver transplantation in univariate and multivariate analyses in cluded:the gender,age,resource of donor,usage of immune inhibitor,time between infection and liver transplantation,infection temperature,primary infection position(intraperitoneal or biliary infection),pathogenic microorganism type,nosocomial infection,inadequate antibiotic usage,serum creatinine level,serum albumin (Alb) level,white blood cell (WBC) in peripheral blood,lymphocyte in peripheral blood,platelet (PLT) in peripheral blood and septic shock indexes.The patients were followed up by outpatient examination and telephone interview up to January 31,2016,the follow-up contents included the survival status of the patients,vital signs,using status of immune inhibitor,immune inhibitor concentration,blood routine,biochemical indexes,surgery,other infection-related complications and acute rejection.Continuous variables with normal distribution were represented as ~ ± s.The univariate analysis was done by the Chi-square test.The multivariate analysis was done by the Logistic regression model.Results (1) The bloodstream infection status after liver transplantation:186 bloodstream infections were happened in 107 patients undergoing liver transplantation,with a total incidence of bloodstream infection of 29.32％ (107/365).The incidence of bloodstream infection was 28.18％ (62/220) in the Third Xiangya Hospital of Central South University and 31.03％ (45/145) in the South Central Hospital Affiliated to Wuhan University,with no statistical difference (x2=0.186,P ＞0.05).Of 107 patients,56 patients had once bloodstream infection,31 had twice bloodstream infection and 20 had three times or more bloodstream infection (frequency of the most bloodstream infection was 6).The inadequate anti-infection treatment was applied to the 41.12％ (44/107)of patients with liver transplantation and bloodstream infection.The number of patients with primary infection positions in abdomen,lung,urethra,intravascular catheter and unknown sites were 40,39,3,1 and 24,respectively.The Gram positive bacteria,Gram negative bacteria,fungus and mixed infection of microorganism infection type were detected in 28,24,4 and 51 patients,respectively.There were 102 patients with nosocomial infection.Bacteria culture results in 186 strains of blood sample illustrated:84 strains were Gram positive bacteria as major pathogenic bacteria,among which enterococcus (31 strains) and staphylococcus aureus (23 strains) were dominant strains.The bloodstream infection-related mortality was 37.38％ (40/107),including 35 patients dying of septic shock.(2) The univariate analysis showed that the gender,resource of the donor,infection temperature,type of microorganism,serum creatinine level,serum Alb level,WBC in peripheral blood,PLT in peripheral blood and septic shock were the risk factors affecting bloodstream infection-related death after liver transplantation (x2=5.801,5.920,13.047,12.776,11.366,7.976,25.173,9.289,51.905,P ＜0.05).The multivariate analysis showed that serum Alb level ＜ 30 mg/L and septic shock were the independent risk factors affecting bloodstream infection-related death after liver transplantation (OR =5.839,44.983,95 ％ confidence interval:1.145-29.767,12.606-160.514,P ＜ 0.05).Conclusion It is prone to happen bloodstream infection after liver transplantation,and serum Alb level ＜ 30mg/L and septic shock are the independent risk factors affecting bloodstream infection-related death after liver transplantation.

Objective To translate and revise the Individualized Care Scale-Patient Version(ICS-P) into Chinese,then to assess the reliability and validity of the Chinese version of the Individualized Care Scale-Patient Version (C-ICS-P).Methods Standard forward-back translation techniques were used in the translation of the ICS-P according to the Brislin translation model.Cross-cultural revision of the translated ICS-P was carried out through group discussion and pretesting.Totally 223 patients were recruited through convenience sampling method from a tertiary hospital in Changsha and investigated using general information questionnaire and the C-ICS-P,and its reliability and validity were assessed.Results The C-ICS-P contained two subscales,and both C-ICS-P-A and C-ICS-P-B contained 3 factors explaining 61.330％ and 65.263％ of the total variance.The dimensions of C-ICS-P-A were clinical characteristics (6 items),personal life characteristics (4 items) and participation willingness (5 items);the dimensions of C-ICS-P-B were clinical care (6 items),personal life care (4 items) and decisional control over care (5 items).The Cronbach's α coefficients of C-ICS-P-A and its dimensions were 0.897,and 0.730～0.774;the Cronbach's α coefficients of C-ICS-P-B and its dimensions were 0.909,and 0.688～0.754.Split-half reliability was 0.856 for C-ICS-P-A and 0.688～0.754 for its dimensions;split-half reliability was 0.889 for C-ICS-P-B and 0.750～0.758 for its dimensions.Analysis of content validity of the C-ICS-P indicated that I-CVI was at least 0.83,S-CVI was 0.943.Conclusion The reliability and validity of C-ICS-P are satisfactory and well meet the requirements of psychological measurement,indicating C-ICS-P is a reliable and valid instrument in the context of Chinese culture.

Objective: To investigate the impact of WHO multimodal hand hygiene improvement strategy (MHHIS) on improving hand hygiene compliance of medical staff of organ transplant ICU. Methods: According to the WHO MHHIS, the hand hygiene compliance and correctness before and after intervention of the medical staff was investigated by using double covert observation method from January 2017 to December 2017. The intervention methods included strengthening education and training, improving hand-washing facilities, setting up hand hygiene reminders, adopting feedback mechanisms, and implementing the PDCA cycle. SPSS software was used to statistically analyze the data before and after the intervention. Results: After the intervention, the rates of compliance and correct hand hygiene of organ transplant ICU medical personnel improved from 22.63%(86/380) and 53.49%(46/86) before intervention to 59.31%(309/521) and 79.94%(247/309) after intervention respectively (χ²=120.060,24.566, P<0.01). The rates of compliance of doctors, nurses, interns, and care workers improved from20.45%(9/44),23.53%(68/289), 21.88%(7/32), and 13.33%(2/15) to 44.83%(26/58), 61.85%(167/270), 66.94%(83/124), and 58.62%(34/58), the differences were statistically significant (χ²=6.594-84.133, P<0.05 or 0.01). The difference in the correct rate of hand hygiene between nurses and care workers was statistically significant (χ²=19.541,10.588,P<0.05), but there was no significant difference in the correct rate of hand hygiene between doctors and interns (χ²=1.353, 0.177, P>0.05). The compliance rate of hand hygiene was 15.38%(22/143), 9.90%(11/111), 27.27%(9/33), 26.97%(41/152), 18.26%(21/115), respectively, before the intervention before the patients, before the aseptic operation, after exposure to the blood body fluid, after contact with the patients, and after contact with the surrounding environment. After the intervention, they were 47.59%(79/166), 38.46%(50/130), 65.82%(52/79), 73.04%(168/230), 61.25%(98/160), the difference was statistically significant (χ²=13.948-78.393, P<0.01 The average daily consumption per day of the department's hand-dried hand sanitizers and antibacterial soaps increased from 4.54 ml and 2.59 ml before intervention to 6.48 ml and 4.15 ml after intervention. Conclusions The WHO MHHIS can effectively improve the hand hygiene compliance of the medical personnel of organ transplant ICU.

Objective To explore the effects of WeChat-based peer supports upon medication adherence and quality-of-life in liver transplant recipients .Methods A total of 63 patients with liver transplantation were conveniently divided into intervention group (n=32) and control group (n=31) depending upon their different follow-up periods .In control group ,routine outpatient health guidance was offered while intervention group received 6-week WeChat-based peer supports . Medication compliance and quality-of-life of two groups were evaluated at Month 3/6/12 post-intervention . Results At Month 3 post-intervention ,as compared with control group ,only non-punctual medication improved significantly in intervention group (P<0 .01);at Month 6 post-intervention ,all aspects of drug adherence improved in intervention group (P< 0 .05) ,at Month 12 post-intervention ,drug adherence ,non-punctual medication and missed dosing improved in intervention group ( P> 0 .05 ) . However , inter-group quality-of-life was not statistically significant at Month 3/6/12 post-intervention .Conclusions WeChat-based peer supports may partially improve the immediate compliance of patients with liver transplantation .However ,long-term outcomes and effects on quality-of-life are worth further researches .

Objective To set up and apply a standardized communication system of adolescents and young adults (AYAs) cancer patients,in order to improve AYAs cancer patients' psychological distress and other negative emotions,as well as promote social support and quality of life of patients.Methods A AYAs cancer patients standardized communication system,suitable for China's national conditions,was preliminarily built.Using randomized controlled trials,a total of 171 subjects,selected from 486 cases of AYAs cancer patients,in the Third Xiangya Hospital of Central South University and Hunan Cancer Hospital from August to September in 2016,were intervened with a set of standardized communication system.The Mental Distress Thermometer (DT),Hospital Anxiety and Depression Scale (HADS),Social Support Rating Scale (SSRS) and Concise Health Status Questionnaire (SF-36) were used as evaluation indexes to observe the psychological distress,emotion,social support and quality of life of the three groups of subjects before intervention,immediately after intervention,1 month after intervention and 3 months after intervention.Results At the follow-up of 3 months after intervention,38 cases were lost,14 cases in communication group (final n =43),11 cases in music therapy group (final n =46),and 13 cases in routine group (final n =44)..There was no significant difference in the evaluation indexes between the communication group,music treatment group and the routine group before intervention (P ＞ 0.05).There were statistically significant differences in scores of psychological pain,anxiety and depression,and social support in the 3 groups,before and immediately after intervention,1 month and 3 months after intervention (P ＜ 0.05).The scores of psychological pain,anxiety and depression,social support and quality of life in the communication group 1 month after intervention were statistically significant compared with those in the music group and the routine group (P ＜ 0.05).Conclusions Compared to music therapy and regular care,the standardized communication system has significant effect on improving the psychological distress of AYAs with cancer,and can also improve their social support level and quality of life.The clinical validation of the standardized communication system can provide reference for psychological rehabilitation of cancer survivors.

Objective The aim of this study was to investigate the possibility of type 2 vesicular monoamine transporter molecular probe,18 F-FP-(+)-DTBZ, in the monitoring of total islet β cell mass in animal models. Methods Two groups of Wistar rats were included in this study. In the type 1 diabetes group ( n = 6 ) , the streptozotocin ( STZ) was intraperitoneally injected at a dose of 65 mg/kg, and the control group ( n= 6 ) was likewisely injected with an equal volume of saline, Micro- positron emission tomography ( PET )/ computed tomography ( CT) imaging was performed at these rats post injection of18 F-FP-(+)-DTBZ at 0. 5, 1, 4, 6, and 12 months after STZ or saline injection, bodyweight and glucose level were also measured. Results The average standardized uptake values ( SUV) in the pancreas in the type 1 diabetes rats were decreased significantly than that of the control group at 0.5, 1, and, 4 months ( P<0.05) , and there was no significant difference at 6th and 12th months ( P>0.05) post injection of STZ and saline. Fasting blood glucose positively correlated with pancreatic SUV in the two groups at 0.5, 1, and 4 months (P<0.05) post injection of STZ and saline. Conclusion 18F-FP-(+)-DTBZ PET imaging is a promising method for dynamic monitoringβcell mass in type 1 diabetic rats.

OBJECTIVE: To explore the application and the effect of early recognition of deteriorating patient program in department of cardiac surgery. METHODS: We used the early recognition of deteriorating patient program in the cardiac surgery groups, including cardiac surgeons, nurses in ward, ICU and operation rooms of the cardiac surgery department, and compared the satisfaction of nurses and doctors, handover time, handover score of critical patients, and rate of unplanned ICU admission before and after the intervention. RESULTS: After using the early recognition of deteriorating patient program, the satisfaction of doctors and nurses was increased, the handover time was lowered 0.56 min/time (t=2.22, P<0.05), the handover score of critical patients enhanced by 19.59 points (t=30.57, P<0.001), the rate of unplanned ICU readmission after the operation reduced by 4.8% (χ2=4.14, P<0.05). CONCLUSION Early recognition of deteriorating patient program can improve the safety of cardiac patients, enhance the self-confidence of nurses and work efficiency.
Cardiology Service, Hospital ; organization & administration ; Critical Illness ; Humans ; Intensive Care Units ; Outcome and Process Assessment, Health Care ; Patient Handoff ; Surgery Department, Hospital ; organization & administration

Objective To investigate the prevalence of nutritional risk and undernutrition of geriatric patients with hip fracture in the department of orthopaedics and analyze the relationship between nutritional risk scores and clinical outcomes.Methods In this prospective cohort study,the baseline demographic data of 235 elderly patients with hip fracture in the department of orthopaedics of Ningbo First Hospital were consecutively recorded from November 2013 to December 2015.The prevalence of nutritional risk and undernutrition,infectious complications,and length of hospital stay were also recorded.The infectious complications and length of hospital stay in patients in different age groups(60-69 years,70-79 years,and ≥80 years)and those with different nutritional risks(<3 points,3-4 points,and ≥5 points)were analyzed.Results All patients without PN EN support during hospitalized durations.The incidence of nutritional risk was 62.98％in 235 elderly patients with hip fracture,twenty patients were undernutritioned by multi-item standard based on Nutritional Risk Screening 2002 nutrition disorder score,and 15 patients were undernutritioned by one-item standard with body mass index.Hip arthroplasty patients had significantly higher nutritional risk than those who had undergone internal fixation(74.04％vs.54.20％,P=0.002).Patients with comorbidities had significantly higher nutritional risk than patients without comorbidities(71.56％vs.55.56％,P=0.011).There were significant differences in infectious complications(2.30％vs.3.91％vs.50.00％)and length of hospital stay[(6.35±0.87)d vs.(8.12±1.13)d vs.(10.85±1.52)d,(8.66±2.06)d vs.(10.45±2.43)d vs.(13.25 ±3.65)d] among patients with different nutritional risks(<3 points,3-4 points,and ≥5 points)(P=0.000).Conclusions Elderly patients with hip fracture has relatatively high nutritional risk.These patients tend to have more complications and longer hospital stay.