According to the related requirements of medical technology clinical application management, the specific implementation approaches of surgery physicians surgery permission management were made, including establishing surgery classification project directory library, developing surgery classification management system and the surgery permission declared, and audit program, and investigating to determine the steps of surgery permission owned by surgery physicians currently, and finding problems and solution measures in implementation surgery permission management. To prevent surgical risk, improve the quality of operation, and evaluate surgical doctors scientifically, it provides management experience and references.

OBJECTIVE To establish a method of polymerase chain reaction(PCR) for detecting staphylococci in positive blood culture bottles.METHODS Genomic DNA in 493 positive blood culture bottles was extracted by guanidine hydrochloride and benzenemethanol,then genes 16S rRNA,ssa and mecA were amplified by PCR to identify staphylococci.Finally,the results of PCR were compared with that of traditional method.RESULTS To compare with traditional method,as the golden standard the sensitivity and specificity of PCR method were 98.6% and 100.0%,respectively,the detection could be finished in four hours.Method of PCR was better than traditional method in detecting meticillin-resistant staphylococci.CONCLUSIONS The PCR-based assay is simple,rapid,sensitive and specific,it can be used to detect staphylococci in positive blood culture bottles.

OBJECTIVE To establish a method of loop-mediated isothermal amplification(LAMP) for detecting Staphylococcus aureus in positive blood culture bottles.METHODS Genomic DNA in 293 positive blood culture bottles was extracted by guanidine hydrochloride and benzenemethanol,then genes ssa and mecA were amplified by LAMP to identify S.aureus.Finally,the results of LAMP were compared with the results of traditional method.RESULTS Twenty-two strains of S.aureus were detected in 293 positive blood culture bottles by LAMP method.Compared with traditional method,the sensitivity and specificity of LAMP method were both 100%,respectively,the detection could be finished in an hour.CONCLUSIONS The LAMP-based assay is simple,rapid,sensitive and specific which can be used to detect S.aureus in positive blood culture bottles rapidly.

Objective To explore the independent risk factors of the prolonged time of retention ICU after type A aortic dissection operation,to establish a corresponding perioperative risk assessment system.Methods A total of 509 consecutive patients with type A aortic dissection were enrolled in the study from September 2011 to May 2016,among which,418 patients received emergency operation.The prolonged retention time of ICU was considered as endpoint event.A perioperative assessment system was established through the analysis of related risk factors of the most common complications after type A aortic dissection operation.The possible risk factors of prolonged retention time of ICU were introduced into a single factor analysis.The meaningful variables in the single factor analysis were introduced into logistic regression analysis.The independent risk factors which were obtained from logistic regression analysis were used to establish risk prediction modeL,and the ROC curve and Hosmer-Lemeshow goodness of fit test were used to evaluate the model.Results The perioperative mortality rate was 8.64％,the prolonged retention time of ICU was 5.06 days,and 98 cases exceeded 7 days.The results of logistic regression analysis showed that age,the history of stroke,obesity,emergency operation,cardiopulmonary bypass time,deep hypothermic circulatory arrest time,renal inadequacy,massive transfusion,hypoxemia,and pulmonary infection were the independent risk factors for prolonged retention time of ICU.Accordingly,a mathematical model was established.The area under ROC cure for prediction model(AUC) =0.761,Hosmer-Lemeshow goodness of fit test P =0.512.Conclusion The logistic model estabhshed in this study can successfully predict ICU retention time after type A aortic dissection operation,and the efficacy was predicted satisfactorily.

Objective To explore the effect of comprehensive nursing intervention on patients′ pain and quality of life after endoscopic sinus surgery.Methods A total of 136 cases who were treated with nasal endoscopic surgery were chosen according to inclusion criteria from June 2015 to May 2016 in hospital and were randomly divided into control group and observation group. Patients in the control group received conventional nursing after nasal endoscopic surgery,while the observation group received extra comprehensive nursing intervention after nasal endoscopic surgery. Pain of patients,nursing satisfaction on postoperative 1 day,and improvement of top 5 of SNOT-20 of two groups were compared.Results Postoperative pain of two groups was none and mild,and postoperative pain response of the observation group was better than that of the control group (P<0.01). Top 5 signs of SNOT-20 were nasal congestion,need to blow nose,inattention,runny nose and tiredness. Top 5 signs of observation group were improved more compared with control group(P<0.01). The total nursing satisfaction of observation group was better than that of the control group (P<0.01).Conclusions Comprehensive nursing intervention could effectively improve the pain response of patients after nasal endoscopic surgery and elevate quality of life of patients and their satisfaction to medical care and nursing.

Public hospitals in the face of COVID-19, should prioritize medical services of patients as the topmost task. In order to ensure the smooth progress of diagnosis and treatment, and prevent the occurrence of nosocomial infection, the hospital took an overall response strategy featuring " logistics support mode 3+ 1" . This strategy requires to make facilities ready by transforming isolation wards, overall management and deployment of protection supplies, optimizing logistics service flow, strict sterilization and isolation of medical wastes and environment, optimizing catering service within the hospital to reduce the gathering and flow of personnel. It also enhanced personnel training, to eliminate staff panic and to stabilize the logistics support team. Meanwhile, the logistics department took over the hospital access screening work for tight access control, which maximize the safety and reliability of the logistics support within the hospital, and ensure the smooth progress of the epidemic prevention work.

Objective: To observe the association between puberty development and thyroid function among school-aged girls in Minhang District of Shanghai, in order to explore the effect of puberty development on thyroid function. Methods: The study was based on a cohort of adolescent girls recruited in iodine-suitable areas of Minhang District, and the baseline and follow-up survey have been carried out from January to March 2019. The method of phased cluster sampling was used to select one junior high school in the east, south, north and middle of Minhang District, Shanghai, respectively. Finally, 464 new junior high school girls were included in the Cohort study for physical examination, and girls were followed up from January to March 2021. The Puberty Development Scale (PDS) was used to assess the stage of puberty. Serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were determined for each participant. Thyroid homeostasis structure parameters (THSPs) was calculated. Changes of Thyroid hormones at baseline and follow-up were compared by Wilcoxon signed rank sum test. Multiple linear regression analyses were used to evaluate the associations of thyroid hormones (THs) and THSPs changes with pubertal develepment. Results: Serum TSH levels of female studentds decreased significantly, while their FT3 and FT4 levels increased significantly during the study period ( Z=-10.53, -4.71, -12.46, P <0.01). In multiple linear regression analysis after adjustment for co-variables (including baseline age, change of BMI and waist circumference), FT4 and thyroid feedback quantile-based index (TFQI) in the higher puberty category scores changes (△PCS) group were further reduced compared with those in the low △PCS group ( β =-0.66, -0.55 ). Compared to the late puberty at baseline and follow-up (BLFL) group, FT4 and TFQI showed higher decline in the pre-puberty at baseline and late puberty at follow-up (BPFL) group with the pre-puberty at baseline and end of puberty at follow-up (BPFT) group ( β =-0.55, -0.44)( P <0.05). There were no association of △TSH, △FT3, △FT4/FT3 and TSH index changes (△TSHI) with △PCS or the puberty pattern. Conclusion Serum TSH decreases while serum FT3 and FT4 increase among girls during puberty. Both the initial stage and the velocity of pubertal development are related to thyroid hormone fluctuations.

Objective:To observe the dynamic changes of serum RANTES during the treatment with nucleos(t)ide analogues combined with pegylated interferon alpha (peginterferon-α), and further analyze the predictive effect of RANTES on HBsAg clearance in patients with chronic hepatitis B.Methods:98 cases of chronic hepatitis B with quantitative HBsAg < 3 000 IU/ml and HBV DNA < 20 IU/ml after≥1 year NAs treatment were enrolled. Among them, 26 cases continued to receive NAs monotherapy, 72 cases received NAs combined with pegylated interferon alpha therapy. The changes in RANTES during treatment were observed. The receiver operating characteristic curve was used to analyze the early changes of RANTES to predict the HBsAg clearance during 48 weeks.Results:During 48 weeks, 15 cases (20.83%) had achieved HBsAg clearance in combination group, while no patient had achieved HBsAg clearance in NAs group. The overall serum RANTES level had decreased from baseline in NAs and combination group. At week 48, in the combination group, the serum RANTES level was decreased more significantly in patients with HBsAg clearance than patients without. Further analysis showed that, in combination group, HBsAg clearance rate of patients with serum RANTES decreased at week 12 and 24 was higher than patients with elevated (29.17% vs. 4.17%, P = 0.014; 28.00% vs. 4.55%, P = 0.052), and quantitative HBsAg reduction was larger significantly [(1.49 ± 1.26) log 10IU/ml vs. (0.73 ± 0.81) log 10IU/ml, P = 0.017; (1.54 ± 1.27) log 10IU/ml vs. (0.57 ± 0.56) log 10IU/ml, P = 0.004]. Receiver operating characteristic curve analysis showed that the baseline quantitative HBsAg and the reduction in quantitative HBsAg and serum RANTES during the early period were predictors of HBsAg clearance after 48-week combination therapy. Furthermore, the combination of baseline quantitative HBsAg and 12 - or 24-week reduction of serum RANTES were better predictors of HBsAg clearance than that of baseline quantitative HBsAg combined with HBsAg decrease at week 12 or 24. The area under the receiver operating characteristic curve of the former was 0.925 and 0.939, while that of the latter was 0.909 and 0.929, respectively. Conclusion:Early reduction of serum RANTES at week 12 and 24 can predict HBsAg loss in CHB patients receiving addition of peginterferon-α to ongoing NAs Therapy, so serum RANTES could be one of the key immunological markers for predicting HBsAg clearance.

OBJECTIVE To optimize the freeze-drying process for sheep placenta slices. METHODS An orthogonal test design was used with pre-freezing time， drying time and drying temperature as indicators to screen for the optimal freeze-drying process for sheep placenta slices. The peptide content， ethanol-soluble extract content， and freeze-drying rate of sheep placenta were used as indicators，the analytic hierarchy process-criteria importance through intercriteria correlation （AHP-CRITIC） method was employed to determine the weight of each indicator and calculate the comprehensive score， which was verified using the technique for order of preference by similarity to ideal solution （TOPSIS） model. RESULTS The optimal preparation process was found to be the pre-freezing time of 2 hours， the drying time of 16 hours， and the drying temperature of 30 °C. The average values of peptide content， ethanol-soluble extract content， and freeze-drying rate for three batches of samples were 5.883 mg/mL， 27.1%， and 95.77%， respectively； the comprehensive scores of three batches were 96.42， 99.18 and 99.58， with RSD of 1.75%. CONCLUSIONS This study successfully optimized the freeze-drying process for sheep placenta slices， which can provide a reference for the quality standard setting and industrial production of this type of slice.