Objective To reveal the hepatitis A vaccine (HepA) coverage among pre-school children in Shandong province before Hepatitis A vaccine was introduced to the EPI and to provide evidence for improving the strategy for hepatitis A control.Methods A cross-section survey was conducted among children aged between 2 and 6 years old in Shandong province in March 2008.The study population was selected by random sampling method and HepA immunization history was obtained by immunization record or recall.Results 78.90% had received one dose of HepA at least.The coverage rate decreased with age and the differences in three age groups were statistically significant (x 2 =11.54,P=0.02).The coverage rates among the boys and girls were 77.67% and 80.30% respectively,the difference was not significantly(x 2 =1.17,P=0.28).The HepA coverage rates among the children living in the eastern areas and in the richer areas were higher than the centrale and western areas and poverty areas,the difference has statistic significance (x 2 =27.25,58.17,P

This paper analyzed medical dispute litigation from the view of game theory.The adoption of mediation strategy for both hospital and patient was the Pareto optimal of this model.The adoption of court decision for both hospital and patient was the Nash equilibrium and its overall benefit was the Pareto suboptimal of this model.The communication of patient's lawyer can prompt the reconciliation between hospital and patient.On the one hand,it let the hospital realize the responsibilities they should bear,on the other hand let patients be willing to make concessions on the basis of the original claims,and finally made the two sides reach a reconciliation agreement,thus to make conflict between hospital and patient end in litigation and the overall benefits maximize.

Objective To investigate the effect of implementation of hand hygiene(HH)activities on HH compliance among health care workers(HCWs).Methods In May-December 2013,a series of HH intervention measures in a hospital were implemented,compliance to HH among all clinical and laboratory HCWs in April-December 2013 (before and after in-tervention)were surveyed and compared.Results After implementing HH activities,HH compliance rate of HCWs in-creased from 39.82% before intervention to 80.77% after intervention,HH compliance rates of doctors,nurses and clean-ing staff increased from 41.09%,41.30% and 34.33% before intervention to 83.87%,91.89%,and 59.54% after inter-vention respectively,the differences between before and after intervention were all statistically significant (all P <0.001). Except intensive care unit,HH compliance rates of HCWs in departments of surgery,internal medicine,and radiotherapy were all higher than pre-intervention(all P <0.001).Compliance to five indications for HH among HCWs after interven-tion were all higher than pre-intervention(all P <0.001 ),HH compliance rate before touching a patient increased from 23.88% to 73.37%,before clean/aseptic procedure increased from 58.65% to 94.23%.Conclusion Through the imple-mentation and supervision of HH activities,both the awareness and compliance of HH among HCWs have been significant-ly improved,good HH habit is gradually developed.

Objective To explore the effect of the prevention and treatment of unstable bladder after suprapubic prostaectomy by capsaicin instilled into the bladder preoperatively combined with patient-controlled epidural analgesia(PCEA)for benign prostatic hyperplasia(BPH).Methods Sixty patients with BPH underwent suprapubic prostatectomy under epidural anesthesia were randomly divided into control group (30 cases)and treatment group(30 cases),100 ml of 100 μmol/L capsaicin was instilled into the bladder preoperatively for 30 minutes combined with PCEA after operation in treatment group,the control group was only given PCEA.Observed the incidence and continuous time of unstable bladder after operation in two groups.Results Unstable bladder was found in 3 cases of treatment group and they were Ⅰdegree,12 cases happened unstable bladder in control group,3 cases Ⅰdegree,5 cases Ⅱdegree,3 cases Ⅲ degree,1 case Ⅳ degree.There was obvious significance between two groups (P＜0.05).Conclusion Capsaicin instilled into the bladder combined with PCEA can cut off the reflex arc of detrusor contraction more completely and has obvious effect of decrease the incidence of unstable bladder after suprapubic prostatectomy and can be used widely.

Objective To systematically review the effectiveness and safety of transcutaneous electricalnerve stimulation (TENS) on symptomatic diabetic neuropathy (DNP). Methods Electronic databases such asPUBMED, EMBASE, Cochrane Central Register of Controlled Trials, and Chinese Biomedical Database weresearched by using such mesh and text keywords as "TENS" and "diabetic neuropathy". Randomized controlled trials(RCTs) on the effect of TENS on symptomatic diabetic neuropathy were included. Studies were selected and availa-ble data was extracted independently by two reviewers. Meta-analysis was performed using RevMan 4.2.8 software.Results Three RCTs involving 78 patients were included in this study. Compared with sham-stimulation, TENStherapy significantly reduced the score in pain (SMD -2.35, 95% CI [-4.24, -0.46 ] ) and the score in numb-ness (WMD -0.18, 95% CI [-0.32, -0.05 ] ). Subgroup analysis shows that TENS therapy was associated with a significant reduction in the score of pain in both 4-week treatment duration ( SMD - 5.37, 95% CI [ - 6.97,- 3.77 ] ) and 6-week treatment duration ( SMD - 1.01, 95% CI [ - 2.01, - 0.01 ] ), but not 12-week treatmentduration (SMD - 1.65, 95% CI [ -4.02, 0.73 ] ). Conclusion TENS therapy is a promising and safe strategyfor treatment of symptomatic diabetic neuropathy. More studies are still warranted to accumulate the evidence of theeffect of TENS therapy on DNP.

Objective To evaluate the diagnostic performance of the histogram analysis of mono-exponential and intravoxel incoherent motion(IVIM) models to the dualistic model of epithelial ovarian cancer(EOC). Methods Forty female patients with histopathologically proven epithelial ovarian cancer underwent preoperative MR examination. Scanning sequences included conventional imaging, diffusion-weighted magnetic resonance imaging with 11 b values (0, 30, 50, 100, 150, 200, 400, 600, 800, 1 000, 1 500 s/mm2) and dynamic contrast enhanced MRI (DCE-MRI). Based on the dualistic model of EOC, all patients were divided into two groups:typeⅠ(low grade, n=16) and typeⅡ(high grade, n=24). ADC, D, D*and f maps and their corresponding histograms were generated by post-processing software. Based on an entire-tumour measurement, the following histogram parameters were recorded, respectively: (a) Mean; (b) the 10th percentile (10th);(c) the mean of the top 10 percent (MeanL);(d) the 90th percentile (90th);(e) the mean of the bottom 10 percent (MeanR). Two types were compared using independent sample t test or Mann-Whitney U test. And areas under ROC curve between two groups were assessed. Results For ADC , D, and f, all indices(Mean,10th,MeanL,90th,MeanR) of the histogram were significantly lower in typeⅡthan in type Ⅰ(P<0.05). All of parameters of D* had no significant different(P>0.05). D demonstrated a comparable accuracy with ADC in differentiating the grade of EOC (area under curve: Mean, 0.898 vs. 0.893; 10th, 0.880 vs. 0.846; MeanL, 0.878 vs. 0.858; 90th, 0.895 vs. 0.839; MeanR, 0.872 vs. 0.814), and both ADC and D have better performance than f. Conclusion It is feasible to stratify the grade of EOC by mono-exponential and IVIM models with histogram metrics,diagnositic efficiency of ADC and D values are higher.

OBJECTIVETo analyze p-coumaril acid, trans-6-O-p-coumaroyl scandoside methyl ester and its metabolites in rat plasma after intragastric administration of exocarpium Diffusa effective extracts.

METHODRat blood samples were collected 1.0 h after oral administration of 0.4 g x kg(-1) exocarpium Diffusa effective extracts, and then were analyzed by using HPLC-Q-TOF-MS.

RESULTIn rat plasma, only one metabolite was detected. The structure was identified by reference substance to be p-coumaril acid.

CONCLUSIONThe methyl glucoside metabolite in rat from the main component parts of trans-6-O-p-coumaroyl scandoside methyl ester droppings of vines in Diffusa effective extracts is p-coumaril acid. This experiment provides a theortical basis for studying chemical compositions and pharmacodynamic action of Diffusa.

Animals ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; administration & dosage ; analysis ; metabolism ; Hedyotis ; chemistry ; Male ; Mass Spectrometry ; methods ; Rats ; Rats, Sprague-Dawley

Objective:To evaluate the clinical efficacy of sepsis in children by dynamic monitoring of serum procalcitonin (PCT) and hypersensitive C-reactive protein (hs-CRP).Methods:Seventy-five children with sepsis hospitalized in Taihe County People′s Hospital from January 2015 to April 2019 were selected as the sepsis group, and 75 healthy children in the same period were selected as the control group. The values of PCT and hs-CRP in two groups were detected by chemiluminescence and immunoturbidimetry respectively, and the levels of serum PCT and hs-CRP were compared between the two groups. According to the PCT, hs-CRP value and APACHE Ⅱ score at 72 h after treatment, children in sepsis group can be divided into two groups: good curative effect group (APACHE Ⅱ <27 scores)and poor curative effect group with (APACHE Ⅱ ≥27 scores).The changes of serum PCT, hs-CRP and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score in two group were monitored dynamically at different time points, and data were analyzed by SPSS 18.0 software.Results:The levels of PCT and hs-CRP in sepsis group were significantly higher than those in control group [(5.37 ± 1.56) μg/L vs. (0.32 ± 0.10) μg/L, (64.6 ± 9.5) mg/L vs. (4.2 ± 1.2) mg/L] ( P<0.01). At 1, 3 and 5 d after treatment, the levels of PCT, hs-CRP value and APACHE Ⅱ scores in good curative effect group were significantly reduced. However, the levels of PCT, hs-CRP and APACHE Ⅱ scores in poor curative effect group did not decrease significantly or even continued to increase, and the levels of PCT, hs-CRP and APACHE Ⅱ scores in good curative effect group at different time point were significantly higher than those in poor curative effect group ( P<0.01). In sepsis group, the level of PCT had positive correlation with hs-CRP and APACHE Ⅱ ( r=0.846, P<0.05; r=0.531, P<0.05), and the level of hs-CRP had positive correlation with APACHEⅡ( r=0.558, P<0.05). The sensitivity and specificity of PCT combined with hs-CRP in diagnosis of sepsis was 98.7% and 93.5%. Conclusions:PCT combined with hs-CRP detection is helpful for the early diagnosis of sepsis, and through the dynamic monitoring of PCT and hs-CRP values, the therapeutic efficacy of children can be evaluated.

OBJECTIVETo study effects of three pentacyclic triterpenoids, oleanolic acid (OA), ursolic acid (UA) and asiatic acid (AA) on Ca(2+)-induced liver mitochondrial permeability transition (MPT).

METHODEffects of three compounds on liver MPT induced by Ca2+ were assessed by measuring the change in mitochondrial swelling, mitochondrial membrane potential and release of matrix Ca2+ in vitro.

RESULTObvious mitochondrial swelling, loss of mitochondrial membrane potential and release of matrix Ca2+ occurred after the addition of 50 micromol x L(-1) Ca2+. However, preincubation with 50 mg x L(-1) OA, UA or AA significantly blocked the above changes. In addition, it was also found that there are differences in the inhibitions of three compounds on liver MPT induced by Ca2+.

CONCLUSIONThree pentacyclic triterpenoids, OA, UA and AA, have significant mitochondrial protection through blocking on liver MPT and the inhibition on liver MPT of AA is stronger than that of UA and OA.

Animals ; Calcium ; metabolism ; pharmacology ; Membrane Potential, Mitochondrial ; drug effects ; Mice ; Mice, Inbred ICR ; Mitochondria, Liver ; drug effects ; metabolism ; Mitochondrial Membrane Transport Proteins ; drug effects ; Mitochondrial Swelling ; drug effects ; Pentacyclic Triterpenes ; pharmacology

As patient autonomy is increasingly valued and respected in clinic,"patient participation" in clinical decision making has been gradually concerned, while it has been also questioned. Through reviewing the history of the concept of "patient participation", this paper expounded the meaning of "patient participation" in clinical decision making and its theoretical and practical significance from the perspective of deontology and utility theory. On this basis, this paper discussed the main practical ethical issues of"patient participation" faced in our country, including the ability and role of patient participation in clinical decision making, the challenge of"families involvement" in clinical decision making to "patient participation", to solve people' s doubts about the practical application of "patient participation" in clinical decision making.