Objective To investigate the effect of implementing the triage standard in pediatric emergency to provide a basis for the nursing triage system.Methods The self-designed questionnaire was adopted to investigate the satisfaction degree on the triage nursing work from patients,emergency nurses,triage nurses and doctors.Results The satisfaction degrees of the patients,doctors and nurses on the triage nursing work after implementation of the triage system were significantly increased compared with before implementation(P<0.05).Conclusion Implementing the pediatric emergency triage system can effectively identify critical chil-dren,make them to obtain timely treatment and conduce to increase the triage quality.

Ecotropic viral integration site-1 (Evi-1) gene is first identified as a binding site for retrovirus in murine myeloid leukemia.The human homologue with the murine in leukemia oncogene Evi-1 is about 91％ of nuclear sequence and 94％ of amino acid.Evi-1 gene is high expressed in myeloid malignancies and other tumors.The main tumorigenic mechanisms of Evi-1 gene include inhibiting TGF-β signal path by depressing Smad3,adjusting cell cycle,promoting angiogenesis,inhibiting JNK.activating AP-1,and so on.

10.3969/j.issn.1007-3969.2013.05.007

Objective: To discuss the therapeutic regimen for warfarin resistant patients with the help of clinical pharmacists. Methods:The pharmacist analyzed the cause of warfarin resistance and provided the dose adjustment for a pulmonary embolism pa-tient. Results:The genotype of the patient was identified as VKORC1-1639AG by gene test. The patient was diagnosed as hereditary warfarin resistance excluding other causes. With the assistance of pharmacist, the problem of warfarin resistant was solved. Conclu-sion:For warfarin resistant patients, clinical pharmacists must definite the reason of warfarin resistant firstly and then carry out the therapeutic strategy. Gene detection may be used as an important guide for warfarin resistance.

Objective To study the assisted diagnostic value and significance in precise surgery of MSCT angiography in torsion of ovar-ian tumors in children. Methods The dual-phase enhanced MSCT images data of 15 children patients with ovarian tumor torsion which were confirmed by surgery were retrospectively analyzed. Showed the vascular changes around the ovaries and judged the ovarian tumors arise and torsion side with the vascular reconstruction methods of multi-planar reconstruction (MPR),maximum intensity projection (MIP),volume rendering ( VR) ,then compared with the operation situation. Results Among the 15 cases aged from 2 months to 11 years old who were de-tected with MSCT scanning and angiography, there were 11 cases of benign tumor (9 cases of ovarian teratoma and 2 cases of serous cystade-noma) and 4 cases of malignant tumor (3 cases of yolk sac tumor and 1 case of malignant mixed germ cell tumor). MSCTA displayed that o-varian vessels changes were abnormal thickening and twisting of distal feeding artery and tumor vascular network formation;and there were thickening, tortuosity, increased density and a few visible‘whirl sign’ in draining veins. Preoperative MSCTA displayed ovarian tumor blood supply arteries were found 5 cases of downlink of ovarian artery and 10 cases of asscending branches of uterine artery. There were 4 cases of ovarian tumor originated from the left ovary combined with reverse and 11 cases originated from the right ovary combined with reverse, which were consistent with intraoperative findings. Intraoperative MSCTA provide information which helped accurate chose of the surgical incision, precise abruption of tumor blood vessels and resection of the tumor and ovarian lesions, thus saved the operation time and reduced the blood loss. Conclusion MSCT angiography can not only provide diagnosis information of torsion of ovarian tumors in children,but also more impor-tantly,it has an important assisted significance in precision surgery.

本文就康复概念的“泛化”现象 ,提出了一些看法。对康复科学、康复系统工程及其对工程技术的需求 ,进行了分析探讨。结论 :康复工程的广义内涵是理清边界、拾遗补缺、设置接口、实现系统集成 ,利用现代工程技术的手段和方法促进残疾者的全面康复。

Objective: To analyze the correlation between the psychological flexibility of newly recruited nurses and the change leadership behavior of head nurses, so as to guide nursing managers to strengthen management and improve the quality of nursing care of new nursing staff. Methods: From May 2017 to April 2018, 80 new nursing staff were surveyed using the psychological resilience scale and the change leadership style, and their correlation was analyzed. Results: According to the statistics, the total score of psychological reinforcement of new nursing staff was (2.74±0.52)points, the overall level was not high, and the head nurses' change leadership behavior and various dimension scores were positively correlated with the nursing staff's psychological elasticity score (r=0.240, P<0.05). Conclusion Nursing managers should give full play to the role of the head nurses' transformational leadership behavior, so as to act on the psychological flexibility of nursing staff and improve the overall level of care.

OBJECTIVE: To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of coronavirus disease 2019 (COVID-19). METHODS: The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Municipal Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed. RESULTS: In the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged. There was no cross-infection occurred in suspected patients during the hospitalization. There were no deaths and no medical staff infections. CONCLUSIONS The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved with MDT, particularly for complicated cases.
Betacoronavirus ; isolation & purification ; China ; Coronavirus Infections ; diagnosis ; therapy ; Humans ; Interdisciplinary Communication ; Pandemics ; Patient Care Team ; standards ; Pneumonia, Viral ; diagnosis ; therapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of corona virus disease 2019 (COVID-19). METHODS: The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed. RESULTS: Of the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times per case. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged; there was no cross-infection occurred in suspected patients during the hospitalization; there were no deaths and no medical staff infections. CONCLUSIONS The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved under MDT mode, particularly for complicated and refractory cases.
Betacoronavirus ; Coronavirus Infections ; complications ; diagnosis ; therapy ; Disease Management ; Humans ; Interdisciplinary Communication ; Pandemics ; Patient Care Team ; standards ; Pneumonia, Viral ; complications ; diagnosis ; therapy ; Retrospective Studies ; Treatment Outcome

BACKGROUND: Compared to other preparation method, chemical extraction can almost removed all cellular components,reduce the possibility of immunological rejection, and remain the integrality of nerve graft. However, there are still problems need to be explored.OBJECTIVE: To investigate the optimal condition of acellular nerve graft using Trito X-100 and sodium deoxycholate as extracting agent.DESIGN, TIME AND SETTING: Randomized grouping, controlled cytology observation. The experiment was performed at the Department of Stomatology, Affiliated Hospital of Binzhou Medical University, from February to June 2009.MATERIALS: Fifteen New Zealand white rabbits, aged 3-4 months, weighing 2.5-3.0 kg. Triton X-100 and sodium deoxycholate were provided by Sigma Company, USA.METHODS: The bilateral facial nerve were obtained from rabbits, and removed the adipose tissue and epineurium of the nerve surface under the surgery microscope, then divided these nerves into 66 segments, with each length of 10 mm. The 66 neurons were randomly divided into 11 groups, with 6 neurons in each group. Except the control group, all neurons were placed into Petri dish for 12 hours bathing using distilled water at room temperature, then 5 groups of which were cultured with Triton X-100 for 12,24, 36, 48, and 60 hours, oscillation at room temperature; the remained 5 groups were cultured with 3% Triton X-100 for 12 hours,followed by 4% sodium deoxycholate for 12 hours, repeated for 1-5 cycles.MAIN OUTCOME MEASURES: Haematoxylin-eosin staining; degrees of decellularization and integrality of fiber pipe.RESULTS: Only use Triton X-100 to deal with the nerve of New Zealand white rabbits, even if 60 hours, could not to remove all the cellular components, and the basement membrane of Schwann cells were greatly destroyed. After 2 cycles treatment of Trito X-100 combined with sodium deoxycholate, cellular components and myelin sheath of nerve fibers and axons were removed effectively, and basement membrane of Schwann cell was remained, with epineurium and perineurium could be seen.CONCLUSION: Oscillation accompanied by 2 cycles treatment of Trito X-100 and sodium deoxycholate can obtain acellular nerve graft by removing cellular components completely, and reserving integrated basement membrane of Schwann cells.