The authors have applied the Omaha system in six different researches conducted in Hong Kong and mainland China in the last ten years. These researches have been conducted using different client groups,specialty nurses,and in the hospital,clinic and community settings. The Omaha system was found to be instrumental in serving as a conceptual framework for study,designing the intervention protocol,identifying clients' health problems,defining nursing interventions and evaluating research outcomes. The Omaha system is a valuable tool for research and practice and is worth exploring further for its application in mainland China,particularly in the areas of community nursing and transitional care.

Objective To explore the clinical effect of escitalopram combined with xingnaojing in post-stroke depression (PSD).Methods Seventy-four cases with PSD were divided into treatment group (38 cases) and control group (36 cases) by random digits table,control group was given escitalopram,treatment group was given escitalopram and xingnaojing.Hamilton depression scale (HAMD),mental state examination (MMSE),memory quotient (MQ) and activities of daily life (ADL) score,clinical curative effect and adverse reaction were compared between 2 groups.Results The HAMD,MMSE,MQ,ADL score after treatment in 2 groups were significantly better than those before treatment [control group:(14.26 ± 2.61)scores vs.(29.73 ± 5.17) scores,(23.26 ± 3.75) scores vs.(21.24 ± 3.38) scores,(86.53 ± 6.49) scores vs.(82.35 ± 5.42) scores,(61.37 ± 3.72) scores vs.(45.32 ±4.48) scores;treatment group:(10.31 ± 2.08)scores vs.(29.57 ± 6.09) scores,(27.83 ± 4.31) scores vs.(21.63 ± 3.82) scores,(95.63 ± 6.41) scores vs.(82.30 ± 7.48) scores,(69.15 ± 6.39) scores vs.(45.27 ± 4.28) scores,P ＜ 0.05].The HAMD,MMSE,MQ,ADL score after treatment in treatment group were significantly better than those in control group (P ＜0.05).The total effective rate in treatment group was significantly higher than that in control group [97.4％(37/38) vs.86.1％(31/36),P ＜ 0.05].There was no significant difference in rate of adverse reaction between 2 groups (P＞ 0.05).Conclusion Escitalopram combined with xingnaojing in PSD is effective and safe,and worth further clinical application promotion.

Objective To explore diagnosis and treatment of thoracolumbar spine and spinal cord trauma complicated by thoracoabdominal viscera injury. Methods A retrospective study was performed on 84 cases with thoracolumbar spine and spinal cord trauma complicated by thoracoabdominal viscera injuries treated in our unit from January 1986 to December 2002, of which there were 52 cases with thoracic vertebra fracture (T_6-T_(12)), 32 with lumbar fracture (L_1-L_4), 70 with complicated chest injury, 14 with abdominal injury and 34 with injuries of cranium, extremities and pelvis. Spinal fixation or decompression of spinal cord was performed in 62 cases, drainage in 22, laparotomy in 10 and exploration of skull in nine. Results Eighty-two cases survived, with follow up period for 6-36 months. According to Frankel standard nerve function recovery showed that among 36 cases at grade A, 10 had partial or sensation recovery and the other got nerve function improvement for gradeⅠ-Ⅲ. Delayed diagnosis and missed injuries totaled seven cases (12%). Two cases were died of postoperative MODS. Conclusions As for patients with thoracolumbar spine and spinal cord trauma complicated by thoracoabdominal viscera injury, a comprehensive clinical examination including X-ray or CT is necessary. The treatment should first focus on thoracoabdominal viscera trauma and try to avoid aggravation of spine and spinal cord injury.

OBJECTIVE To prevent the nosocomial infection event in the clinical laboratory.METHODS To improve the management,amplify necessary rules and regulation,fine study and training,and do well in self-protection among department staff.Abacterial technical operation be carried out strictly.Keep the rooms clear,and disinfect the instrument and medical garbage.RESULTS By means of above mentioned management and prophylaxis,to control the risk factors of nosocomial infection in clinical laboratory.CONCLUSIONS The management and controlling measures of risk factors in clinical laboratory are the keys to prevent the nosocomial infection event in clinical laboratory.

Objective To express recombinant Vp1 protein of chlamydiaphage φCPG1, prepare monoclonal antibody against Vp1 protein and utilize it to screen clinical isolates of Chlamydia trachomatis. Methods The Vp1 protein was obtained by prokaryotic expression, and monoclonal antibody against this protein was prepared by hybridoma technique. ELISA and Western blot were used to identify monoclonal antibodies. Then,the monoclonal antibody was prepared in quantity by injecting hybridoma cells into the abdominal cavity of BALB/C mice, and purified by using protein G affinity chromatography. Clinical isolates of Chlamydia trachomatis were screened for the chlamydiaphage by immumofluorescence assay using the prepared monoclonal antibody.Results Purified Vp1 protein was obtained. The monoclonal antibody against Vp1 protein was gained after 3times of sub-clone and consistently identified as IgG1. Three hybridoma cell strains that stably secreted monoclonal antibody were generated. Chromosome analysis of hybridoma cells showed that the mean number of chromosome was 96, most of them were telocentric and a few were submetacentric. The titer of purified monoclonal antibody was more than 1: 12 800. Twenty clinical isolates were screened by using the monoclonal antibody and no positive results were obtained. Conclusions The monoclonal antibody against Vp1 protein of chlamydiaphage φCPG1 is successfully prepared, while no chlamydiaphage is detected by immumofluorescence assay using the prepared antibody in 20 clinical isolates of Ct.

Objective To optimize immunodominant protein combinations for serological screening for Cblamydia trachomatis (Ct) infection.Methods Both serum and genital swab samples were collected from 50 patients with Ct infection confirmed by colloidal gold immunochromatographic assay (GICA),and 30 GICA-negative clients without Ct infection at a sexually transmitted disease (STD) clinic in Tianjin Medical University General Hospital.The 30 serum samples from GICA-negative clients were also negative for microimmunofluorescence (MIF) assay.Eight Ct immunodominant proteins,including Pgp3,CPAF,CT143,CT101,CT694,CT875,CT813 and IncA,were selected as antigens to detect corresponding antibodies in the serum samples by enzyme-linked immunosorbent assay (ELISA) with the Ct proteins Hsp60 and major outer membrane protein (MOMP) as references.The results of ELISA were compared with those of the traditional gold standard method MIF assay to determine the immunodominant protein combination with the highest sensitivity and specificity.Results Of the 50 serum samples from patients with Ct infection,44 were positive and 6 negative by MIF.The results of ELISA with the combination of immunodominant proteins Pgp3,CT694 and CT875 as antigens were 97.73％ (43/44) consistent to those of MIF assay.Of the 30 serum samples from GICA-negative clients,all were negative by MIF.Meanwhile,no antibody was detected against any of the immunodominant proteins Pgp3,CT694 and CT875 in any of the serum samples from GICA-negative clients.Conclusions The ELISA with the combination of immunodominant proteins Pgp3,CT694 and CT875 as antigens has good sensitivity and specificity for serological screening for Ct infection,and is simple to operate and easy to popularize.

Objective To investigate the capability of empathy for pain in bipolar disorder (BD). Methods Thirty-two patients with BD (16, 8 and 8 in depressed, manic and remitted phases, respectively) and 32 healthy controls matched for age, gender and education were recruited. Empathy for pain paradigm were used. Subjects were required to judge whether the person in the picture felt painful and rate pain degree regarding to painful and neutral pictures. Accuracy, reaction time and ratings of pain degree were used as indicators of empathy for pain. Chinese version of Interpersonal Reactivity Index (IRI-C) were used to measure empathy. Results Compared to controls, accuracy of painful pictures was significantly lower in patients [(0.74±0.16) vs.(0.83±0.10), P<0.05]. Reaction time for both painful [(903.84±167.49) ms vs. (765.06±108.21) ms] and neutral [(880.44 ± 190.36) ms vs. (750.31 ± 103.15)ms] pictures were significantly longer in patients (P<0.05). Pa?tients showed lower scores in factors of perspective taking [(9.20±5.43) vs. (12.43±4.13)], fantasy [(11.85±4.57) vs. (15.50± 5.56)] and empathy concern [(14.59±5.35) vs. (17.63±3.37)] in IRI-C (P<0.05). Accuracy of painful pictures was positively correlated with scores in fantasy (r=0.37, P=0.04) and reaction time was positively correlated with duration of disease in pa?tients (r=0.64, P<0.01). Conclusion Bipolar disorder has deficit in the capability of empathy for pain.

A complete hospital security system is essential for the life and property safety of medical workers, patients and their families alike. The successful operation of the system depends on a reasonable staffing of the security department.From 2019, a tertiary hospital has explored and practiced the staffing management of security guards based on the actual needs of the hospital. The first job was to classify its security posts setup, and determine the staffing requirements of front-line security posts based on such indicators as scale, risk and people flow. The management range theory was called into play, to set the staffing coefficient of front-line security posts and their corresponding frontline administrators as 7∶1, and set that each management post needs one middle manager. The next job was to calculate the number of security guards per workload/post. The calculations estimated that the number of guards required for the four front-line security posts, namely, gate keeper post, public area patrol post, security and fire control post, and emergency response unit post, was 37, 46, 26 and 26 respectively. The corresponding management posts, namely, the office of the security department, the security management team, the fire management team, and the order maintenance team, required 7, 8, 5 and 5 management personnel respectively, totaling 160. Based on the calculations, the hospital optimized its staffing, and increased its total security personnel from 150 to 160, including the number of gate keeper posts were reduced by 17, and the number of emergency response unit posts was increased by 22. This optimization has effectively empowered the security department in dealing with medical disputes and emergencies, as well as identifying fire hazards, which serves a reference for the rational staffing of hospital security human resources.

Objective:To summarize the clinical experiences of managing patients with novel coronavirus(2019-nCoV) infection after kidney transplantation.Methods:Clinical data were retrospectively analyzed for two patients with 2019-nCoV infection after renal transplantation in January 2020. Case 1 was a 48-year-old male with CMV pneumonia secondary to 2019-nCoV infection at 4 months post-transplantation. CT imaging showed multiple patchy ground-glass opacities of both lungs. Case 2 was a 59-year-old male who screened positive for 2019-nCoV nucleic acid due to fever at 9 days post-transplantation and he showed no clinical manifestations of pneumonia. After a definite diagnosis, case 1 was transferred to a designated hospital for isolation. Treatment regimens: cefoperazone sulbactam sodium plus linezolid for anti-infection, gamma globulin for enhancing immunity, methylprednisolone for controlling inflammatory responses and antiviral regimens of arbidol tablets plus lopina-velitonavir tablets. Case 2 was isolated in a single room. The treatment plan included cefoperazone sulbactam sodium for anti-infection, gamma globulin for enhancing immunity, arbidol for antiviral therapy and other symptomatic measures.Results:During a follow-up period of 3 weeks, case 1 recovered with renal dysfunction, nucleic acid test of nasopharyngeal swab turned negative and pulmonary imaging improved. Case 2 showed no obvious clinical symptoms and nucleic acid test of nasopharyngeal swab turned negative thrice.Conclusions:Renal transplant recipients should take precautions to avoid exposure to high-risk environments. A definite diagnosis should be made on the basis of clinical manifestations and results of nucleic acid test and pulmonary imaging. Currently there is no effective antiviral agent and symptomatic treatment is a major option.