Objective To investigate the influence of PBL combined with CBS education on reporting cognition and reporting intention of adverse events.Methods Using convenience sampling method,66 registered nurses working for over 6 months were extracted as the study object.The training group was set up and the training files were established,PBL combined with CBS mode were implemented for 6 months from March to August 2013,once a month,2 hours per time.Training cases were designed and written,teaching staff was organized to carry out the training,problems were raised in class and discussed on site.Training staff looked up relevant data,collected information,organized another focused discussion and summarized the results.The Adverse Event Reporting Cognitive Questionnaire and Adverse Nursing Event Reporting Intention Questionnaire were adopted to evaluate reporting cognition and reporting intention before and after the training.Results After the implementation of PBL combined with CBS education,cognition of nurses for adverse events scored (7.23±1.20),higher than that before the intervention,(6.48±1.49),t=3.17,P ＜ 0.01.The numbers of nurses to report adverse events such as potential vulnerabilities and not doing any harm were 42 and 45 before the intervention,while 53 and 56 after the intervention.Conclusions Using PBL combined with CBS model to implement educational interventions can improve reporting cognition and report intention on nursing adverse events of nurses.

Adult ; Aged ; Cystostomy ; Drainage ; methods ; Humans ; Male ; Middle Aged ; Pneumothorax ; complications ; therapy ; Retrospective Studies ; Silicosis ; complications ; therapy

AIM:To develop a method for determining cholic acid by HPLC-ELSD and GC was applied to determing muscone;in Jawei Xihuang Soft Capsule(Calculus Bovis,Moschus,Venenum Bufonis,Olibanum,Myrrha).METHODS:AC_(18) column(Kromasil C_(18),5 μm,4.6 mm×250 mm)was used as stationary phase,the mobile phase was methanol-0.01% glacial acetic acid(73:21)at a flow rate of 1.0 mL/min.The parameters of ELSD were set as follows:evaporation temperature was 40℃,carrier gas(N_2)pressure was 200 kPa.The GC system consisted of DB-1 capillary column(30 m×0.32 mm×0.25 μm)and FID as the detector.The programmed temperature-GC and internal standard method were employed to determine the content of muscone.RESULTS:The linear ranges of cholic acid and muscone were in the range of 45.2 ng-904 ng and 0.05 mg/mL-0.5 mg/mL respectively.The average recoveries were 99.06% and 99.40% with RSD of 1.56% and 0.95% respectively.CONCLUSION:The method is convenient and accurate,and it can be used for the quality evaluation of Jawei Xihuang Soft Capsule.

Objective:Based on relevant database data analysis,to explore the correlation of the abnormal expression of EMT related factors and chronic obstructive pulmonary disease and its related non-small cell lung cancer.Methods: Based on some data sets of GEO in the NCBI database,to perform express analysis,survival analysis and correlation analysis.Results: ①Snai1 and other EMT related regulatory factors exist significantly higher expression in non-small cell lung cancer patients,and E-cadherin (CDH1) was showed significantly lower expression. ②A large number of COPD patients samples were analyzed,and some EMT-related molecules in patients with COPD also showed significant abnormal expression and consistented with the changes in patients with non-small cell lung cancer.Conclusion: The results showed that dysregulation expression of EMT related regulatory factors may have some correlation with disease progression of COPD patients through the EMT markers and their expression and correlation analysis in COPD patients.

Adult ; Case-Control Studies ; Comet Assay ; DNA Mutational Analysis ; Female ; Humans ; Male ; Micronucleus Tests ; Middle Aged ; Occupational Exposure ; Vincristine

AIM:To develop a method for determining cholic acid by HPLC-ELSD and GC was applied to determing muscone;in Jawei Xihuang Soft Capsule(Calculus Bovis,Moschus,Venenum Bufonis,Olibanum,Myrrha).METHODS:A C18 column(Kromasil C18,5 ?m,4.6 mm?250 mm)was used as stationary phase,the mobile phase was methanol-0.01% glacial acetic acid(73:27) at a flow rate of 1.0 mL/min.The parameters of ELSD were set as follows:evaporation temperature was 40 ℃,carrier gas(N2) pressure was 200 kPa.The GC system consisted of DB-1 capillary column(30 m?0.32 mm?0.25 ?m) and FID as the detector.The programmed temperature-GC and internal standard method were employed to determine the content of muscone.RESULTS:The linear ranges of cholic acid and muscone were in the range of 45.2 ng-904 ng and 0.05 mg/mL—0.5 mg/mL respectively.The average recoveries were 99.06% and 99.40% with RSD of 1.56% and 0.95% respectively.CONCLUSION:The method is convenient and accurate,and it can be used for the quality evaluation of Jawei Xihuang Soft Capsule.

According to the target-model of the health care system and characteristics of the health financing system,it is proposed in the paper that the charges of medical services should be the main revenue of public hospital compensation.Efforts should be made to adjust health care service prices and strengthen pharmaceutical management simultaneously so as to rebuild the structure of medical service charge.Medical insurance should make the majority in the compensation to cover most the medical expenses,with government subsidies supporting development.Both government financial investment and medical insurance should join their efforts for planning-guidance and performance-guidance.The authors also suggested to improve a graded and normative diagnoses and treatment system,regulate medical behaviors of public hospitals and their cost standards,justifying the total compensation and standard verification of such hospitals.

The paper summarized the explorations of public hospital pilots in the compensation mechanism and identified the following findings.For example,by means of fiscal support of public hospital infrastructure and development spending,cancellation of drug markup,higher service prices, and reformed payment mode of medical insurance,these hospitals have made initial changes at their business operating mechanism, motivation-guidance of compensation, and their makeup of medical revenue.In addition,such hospitals are found with lower cost of medical care per visit,and higher income of medical workers.The authors also pointed out such problems as inflated drug pricing and expenses,lack of scientific pricing mechanism for medical services,vague definition of policy-related losses,and old-fashioned practice of government investment and health insurance payment.Based on such findings,the paper advised to adjust health care prices by stages and to improve the management of health insurance and the coherence of compensation mechanism.

Abstract:Objective To detect the expression of hepatic function indices and autoantibodies in patients with chronic hepatitis B patients, patients with autoimmune liver disease and patients with chronic hepatitis B combined with autoimmune liver disease, and to evaluate the clinical significance of autoantibodies and hepatic function indexes in the early diagnosis of chronic hepatitis B combined with autoimmune liver disease.Methods A total of 109 healthy controls (HC), 72 patients with chronic hepatitis B (CHB), 74 patients with autoimmune liver disease (AILD), and 24 patients with chronic hepatitis B combined with autoimmune liver disease (CHB+AILD) in the Fifth People’s Hospital of Suzhou from 2013 to 2021 were enrolled in this study. Basic information and the value of admission hepatic function indexes and autoantibodies were collected for all enrolled samples, while no autoantibody test was performed for healthy volunteers. All data were processed using GraphPad Prism and SPSS software.Results There were no significant differences in age and gender among the four groups. The detection rates of anti-mitochondrial antibody M2 (AMA-M2) and anti-soluble acidic phosphorylated nuclear protein antibody (anti-SP100 antibodies) in CHB+AILD group [29.2%(7/24), 17.4%(4/23)] were significantly higher than those in CHB group [5.1%(3/59), 0(0/59)], suggesting that the detection of these two autoantibodies is helpful to the differential diagnosis of CHB and CHB+AILD. In addition, eight hepatic function indexes displayed significant differences among the four groups. The levels of total bilirubin and direct bilirubin in CHB+AILD group were significantly higher than those in CHB and AILD groups, while the levels of total protein and albumin were significantly lower than those in CHB and AILD groups. Alkaline phosphatase and glutamyltranspeptidase in AILD group and CHB+AILD group were significantly higher than those in CHB group. The logistic regression analysis showed that total bilirubin, direct bilirubin, albumin, alanine aminotransferase and alkaline phosphatase could form a promising prediction model, which was useful for clinicians in the differential diagnosis of CHB and CHB+AILD (area under the curve, AUC=0.902).Conclusion The combination of autoantibody and hepatic function index detection can be helpful for clinicians in the differential diagnosis of CHB, AILD and CHB+AILD, thus contributing to the early and correct diagnosis of CHB+AILD and providing theoretical basis for patients to obtain reasonable treatment and clinical cure earlier.

A stimulate method for determination of polybrominated diphenyl ethers ( PBDEs) and derivatives (OH-PBDEs and MeO-PBDEs), tetrabromobisphenol A (TBBPA), hexabromocyclododecane (HBCD) in egg samples was developed by gel permeation chromatography ( GPC) and dispersive solid phase extraction ( DSPE) combined with liquid chromatography tandem mass spectrometric ( HPLC-MS/MS) and gas chroma-tography-negative chemical ionization mass spectrometry ( GC-NCI/MS ) . The analytes were extracted with mixture of hexane and dichloromethane (1∶1, V/V) by accelerated solvent extraction (ASE), and purified by 100 mg C18 dispersive solid phase extraction ( SPE) sorbents followed with gel permeation chromatography (GPC) , and then analyzed by liquid chromatography tandem mass spectrometric (HPLC-MS/MS) and gas chromatography-negative chemical ionization mass spectrometry (GC-NCI/MS), respectively. The quantita-tion was carried out external standard method. The recoveries of objects were 64. 5%-97. 2% and 65. 6%-109 . 2% ( except BDE85 was 54 . 8%, OH-BDE-137 was 47 . 4%) spiked at 1 . 0 μg/kg or 5 . 0 μg/kg in egg white and egg yolk, respectively. The relative standard deviations (RSDs) were less than 20. 2%. The limits of quantitation (LOQ) for the object were 0. 01-0. 2 μg/kg.