1.Evaluation System of Management Efficiency of Hospitals' Medical Instruments
Chinese Medical Equipment Journal 2003;0(11):-
Objective To evaluate the efficiency of the management of medical equipment. Methods Ergonomics was applied to analyze the influence of Man-Machine-Environment System. Results Based on the actual cases, the improved procedure for equipment quality was realized and the management of purchase items were evaluated in quantification. Conclusion The efficiency of the management of medical equipment can be evaluated by using this method.
2.Inspirations from the US experiences in handling medical disputes and legislature
Chinese Journal of Hospital Administration 2009;25(4):243-246
Commercialization of the doctors sector and lawyers sector, and that of medical services, sharp rise of medical disputes and its impact on healthcare services have grown into major challenges for the healthcare system in the United States where litigation is the legal way out of medical disputes at large.Anglo-American law system depends heavily on precedence as the criteria and the majority of such disputes trials are held in state courts, there is also a complete system of laws and decrees on medical disputes on the federation level.In an effort to handle medical disputes that are rising sharply in a piling-up amount, American lawyers, social organizations of arbitration and medicine, and many state courts are seeking alternative dispute resolution as a better way out for medical dispute mediation and resolution.Given the gaps between China and USA in social systems, legal systems, ,economic development, cultural background, healthcare systems and heahhcare security systems, these experiences will prove their value of reference for medical disputes resolution in China.
3.Decreased phosphorylation of cPKC?-interacting ERK1/2 in the hippocampus of hypoxic preconditioned mice
Nan ZHANG ; Song HAN ; Junfa LI
Basic & Clinical Medicine 2006;0(03):-
Objective To determine the changes in phosphorylation of conventional protein kinase C?(cPKC?)-interacting extracellular signal regulated kinase 1/2(ERK1/2) in the hippocampus of hypoxic preconditioned(HPC) mice.Methods Healthy male BalB/c mice were used to develop "auto-hypoxia"-induced HPC mice and randomly divided into 3 groups as follows: normoxic control(H0),early(H3) and delayed hypoxic preconditioned groups(H6).Co-immunoprecipitation and Western blot were applied to quantitatively analyze the phosphorylation level of cPKC?-interacting ERK1/2 in cytosolic and particulate fractions of hippocampus of HPC mice.ResultsERK1/2 was co-immunoprecipitated by cPKC? in hippocampus of mice.The phosphorylation level of cPKC? interacting ERK1/2 at tyrosine 204 decreased significantly in the hippocampus of H3 and H6 groups as compared with that of the H0 group(P
4.THE EXPRESSION OF C-erbB-2,p16 AND nm23-H_1 PROTEIN IN TISSUES OF NASOPHARYNGEAL CARCINOMA AND THEIR RELATIONS WITH PROGNOSIS
Nan ZHANG ; Lihong WANG ; Chunhua LI
Cancer Research and Clinic 2000;0(01):-
Objective:To explore the relation of the expression among C-erbB-2,p16 and nm23-H 1 protein in tissues of nasopharyngeal carcinoma(NPC)and its clinical significance.Methods:SP TMimmunohistochemical technique was used to detect the positive expression rate of C-erbB-2,p16 and nm23-H 1 protein in NPC tissues.Rusults:①The positive rates of C-erbB-2,p16 and nm23-H 1 in low differentiated squamous cell carcinoma were 58.75%,47.5% and 35%,while in undifferentiated squamous cell carcinoma, they were 86.67%,31.11% and 60% respectively. ②Their expression rate were significantly correlated with the clinical staging(P
5.Evaluation of the bilateral approach through triceps brachii for the treatment of intercondylar fractures of the humerus
Guilin ZHANG ; Nan LI ; Mingjiang YI
Chinese Journal of Orthopaedics 2001;0(05):-
Objective To introduce a new bilateral triceps brachii approach for the treatment of intercondylar fractures of the humerus, and explore the possibility for the operation without injuring the mechanism of extension of the elbow. Methods With fresh cadaver specimens, the triceps brachii was stripped off from the distal end of the humerus, the muscle belly was elevated and retracted bilaterally, then the height was recorded, and the exposure of the distal humerus was observed, especially to the trochlear region when the elbow were flexed at 15? , 30? , 45? , 60? , 80? respectively. Results Through the cadaver specimen observation and the clinical application, the reduction and fixation of the intercondylar fractures of humerus should be performed when the elbow is flexed at 45?- 60?, at 15?- 30? flexion, fracture over the supracondylar can be treated and finally at 80? flexion, the reduction of the trochlear region can be examined. Conclusion This bilateral approach through the triceps brachii is suitable for the treatment both of the intercondylar and epicondylar fractures.
6.Characteristics of pedicle screw fixation for thoracolumbar burst fractures among middle and old aged patients
Guilin ZHANG ; Nan LI ; Maoqi GONG
Chinese Journal of Orthopaedics 1998;0(12):-
Objective To discuss methods of pedicle screw fixation for thoracolumbar burst fractures among middle and old aged patients with different degree of osteoporosis, and to improve the clinical result by individualized treatment according to fracture characteristics. Methods There were totally 25 patients, 17 males, and 8 females. These patients with a mean age of 52 years (range, 43-63 years), had suffered from thoracolumbar burst fractures consisted of 1 T11 fracture, 6 T12 fractures, 8 L1 fractures, 7 L2 fractures, 3 L3 fractures. According to Jikeis osteoporosis grading system, 5 patients were of early stage, 7 of stage Ⅰ, 13 of stageⅡ. Posterior stabilization with the short-segment pedicle screw system were given to all the patients, among which 6 RF, 8 AF, 5 USS, 6 Socon were performed. Fifteen patients received anterolateral decompression, and ten patients accepted no decompression at all. Some measures were taken in order to enhance the fixation stiffness for pedicle screw system, such as increasing the screws diameter, using the vertebral body reducer to reduce the depressed vertebral body and so on. To enhance vertebral body strength after fracture union, transpedicular bone graft was also performed. Results All the patients achieved fracture union during the follow-up with a mean period of 28 months (range, 9-48 months). All of the fractures were reduced satisfactorily, SI (sagittal index) was improved from 53% to 89% after operation. No fracture of screws or rods occurred, also no screw loosened. No reduction loss was found. Conclusion In order to decrease failure rate of pedicle screw fixation for thoracolumbar fractures among middle and old aged patients, osteoporosis of vertebral body should never be neglected and, of course, treatment should be given with individualized fixation.
7.Elbow joint function after shortening fixation of the comminuted olecranon fractures
Guilin ZHANG ; Mingjiang YI ; Nan LI
Chinese Journal of Orthopaedics 1996;0(10):-
Objective The olecranon is likely to become shorter following the treatment of its comminuted fractures, which will lead to the compromise of the function of elbow joint. So through the cadaver experiment, introduce the method of making different thickness and direction in osteotomy so as to intimate the shape change of the olecranon after the comminuted fractures, and explore its effect on the flexion-extension function of the elbow joint. Methods Through three cadaver(six arms), osteotomy at 25 mm below the olecranon process was made horizontally and fixed with two screws temporarily, furthermore, the bone fragment of 1 mm, 3 mm and 5 mm in length was resected in order, then specimens were divided into two groups: In the first group, osteotomy was made up to 7 mm and 8 mm continually, and the changes of the range of the elbow joint movement were measured; in the second group, the additional wedge osteotomy of 5 mm and 7 mm was performed respectively, then the outcomes between the two groups were compared. Results If the osteotomized bone was within 3 mm, shortening internal fixation was satisfactory for the reconstruction of the elbow joint function. However, in cases of osteotomized bone of 5 mm, the extension function would be limited as the loss of the trochlear notch is too much. In order to keep the normal range motion of the elbow, the dorsal cortex distal to osteotomy should be scarified about 3 mm for the wedge osteotomy. When the shortage attained to 7 mm, the elbow instability would occur, even if advanced wedge osteotomy was accomplished. Conclusion In cases of the comminuted olecranon fractures, if the osteotomy is made within 3 mm, the shortening fixation is appropriate; if it has not exceeded 5 mm, the fracture should be treated with advanced wedge osteotomy tilting back to keep the radian of the trochlea; and if it has reached 7 mm, bone grafting is necessary for recovering of the flexion-extension of the elbow joint.
8.Stereotactic radiosurgery for cerebral cavernous angioma
Nan ZHANG ; Li PAN ; Jiazhong DAI
Chinese Journal of Radiation Oncology 1993;0(03):-
16?Gy) of STRS seems to reduce the incidence of rebleeding after radiosurgery. However,there is no histopathologic evidence of vascular obliteration in the resected CCA specimens after radiosurgery. The benefits and risks must be carefully balanced before the use of radiosurgery for cerebral cavernous hemangioma.
9.Evaluation of biocompatibility of fiber-reinforced dental composites
Wenyun ZHANG ; Yi SHEN ; Nan LI
Medical Journal of Chinese People's Liberation Army 1981;0(04):-
Objective To evaluate the biological compatibility of dental nano-silicon dioxide/high-strength-glass fiber/EAM resin composites(FRC). Methods Experiments of general acute toxicity, cytotoxicity, hemolysis and mucous membrane irritation were performed on the newly developed FRC. Results The newly developed FRC induced no cytotoxicity, hemolysis, acute toxicity or mucous membrane irritation. Conclusion The newly developed FRC has good biocompatibility in vitro and vivo.
10.Influence of Anxiety of Caregiver on Disease Management of Preschool Asthma Children
Li SHEN ; Nan SHENG ; Ying ZHANG
Journal of China Medical University 2017;46(1):41-44,49
Objective To describe the anxiety of caregivers and condition management of preschool asthma children ,and analyze the relation?ship between anxiety and disease management. Methods A total of 208 caregivers of asthma children from two hospitals in Shanghai were select?ed using convenient sampling,and surveyed by self?rating anxiety scale(SAS),condition management ability scale and condition management diffi?culty scale. Results The score of SAS were negatively correlated with the condition management ability and positively correlated with the condi?tion management difficulty. Hierarchical regression analysis showed that the model explained 26.6%amount and 35.1%amount of variation respec?tively. Conclusion The anxiety of caregiver of children with asthma may affect the disease management. Future interventions should be strength?ened on the caregivers'psychological problems,so as to improve disease management and control asthma more effectively.