Objective To improve EP9-A2 for Bias estimation among multiple quantitative detection systems within full range of AMR.Methods 40 patients specimens were determined twice for serum total cholesterol by four detection systems(A,B,C and D).With system A served as comparative method,Bias between A and the other three was evaluated according to CLSI EP9-A2 separately.Furthermore,DD(distance from deviation to tolerable error)and its average confidence intervals between every two sys-tem were calculated and compared with zero.The confidence interval of greater than zero was served as criteria for accepting bias between every two system.Results Bias between A and the other three meet the analytical quality specification according to EP9-A2,although that of D system was positive,and those of B and C system were negative.DD between every two system obeyed nor-mality distribution.All biases between every two system wes acceptable except that between B and D,causing of their interval con-taining zero.After correcting of results from system D,Biases between every two system were all acceptable.Plots of confidence in-terval could provide a full range bias assessment within AMR.Conclusion Comparability and Bias estimation in full range of AMR for results between every two system among 3 or more systems could be evaluated by confidence intervals.

Objective To observe the therapeutic effects of stellate ganglion block (SGB) with oxycodone and acetaminophen tablets on the treatment of migraine. Methods 100 patients with migraine were divided into two groups randomly. They received SGB with oxycodone and acetaminophen tablets (experimental group) or only SGB (control group) respectively. The parameters included pain intensity before and 1 d,3 d,1 w,1 m and 3 m after the treatment, and pain relief rate of each patient. The adverse effects were also evaluated. Results The pain intensity described as numeric rating score (NRS) decreased in the two groups at each time point. In the experimental group, the value of NRS was significantly less than that in the control group at 3d,1m and 3m after the treatment. The effec-tive rate ha the experimental group and the control group were 88% and 68%. Conclusion SGB with oxycodone and acetaminophen tablets is more effective for migraine and deserves widely used in patients.

Objective To observe the effect of pulsed radiofrequency (PRF) on refractory infraorbital neuralgia. Methods From January, 2012 to December, 2014, 49 patients who received ineffective conservative therapy including medicine and nerve blockade underwent PRF treatment. Postoperative Numeric Rating Scale (NRS)=0 or 50%diminution of NRS was considered effective. NRS, effective rate, addition-al carbamazepine dosage and side effects were recorded on the first day, the first week, the second week, the first month, the third month, the sixth month, the first year, and the second year after operation. Results The effective rate were 67%, 67%, 65%, 59%and 51%on the first month, the third month, the sixth month, the first year, and the second year after operation, respectively. No serious side effect was observed, except that eight patients felt short-term (within one month) mild numbness. Conclusion PRF technique is safe and effective for refractory infraorbital neuralgia, and may become an alternative therapy.

Objective To design a set of feasible program of data monitor based on the database's security of the "No.1 Military Medical Project" in many years of running successful operation to enhance safety audit of database.Methods The system was consisted with date's collection of active and passive for safety information,preservation of backup data,and analysis of credibility dictionaries and auditing.Results The complete processing program of network security monitor which could form alarm message and advance corresponding disposal plans was came into being and its better reliability.Conclusion By using the way,the question of the "No.1 Military Medical Project" in database monitoring is solved in network environment and ensured safe operation of database,the network security of the "No.1 Military Medical Project" system is promoted.

Objective To investigate the current status of nursing undergraduate students′ self-differentiation and career adaptability and analyze the correlation of the two, so as to provide a reference for nursing educators to offer employment guidance. Methods The Undergraduate Self-Differentiation Scale and The College Students′Career Adaptability Questionnaire were used to investigate 341 nursing undergraduates. Results The mean scores of the self-differentiation and the career adaptability were (3.70±0.60) points and (3.60±0.42) points, respectively. It showed that the total score of self-differentiation and its each dimension were positively correlated with career adaptability, the Pearson correlation coefficients were career adjustment 0.26, career interpersonal 0.38, career curiosity 0.32, career confidence 0.39, career concerns 0.27, career control 0.46, and the coefficients between two total scales were 0.46 (all P<0.05). Conclusions The self-differentiation level of nursing undergraduates could affect their career adaptation level, and clinical nursing educators can take corresponding measures to improve their career adaptability based on the characteristics of nursing students′self-differentiation.

Objective To observe the effect of radiofrequency thermocoagulation on patients with refractory supraorbital neuralgia Methods From February, 2007 to September, 2014, 36 patients with refractory supraorbital neuralgia following ineffective conservative ther-apy including medicine and nerve blockade underwent radiofrequency thermocoagulation. Numeric Rating Scale (NRS), Patient Satisfaction Scale (PSS), onset time, effective rate, recurrence rate, additional carbamazepine dosage and side effects were recorded before, and one day, one month, three months, six months, one year, two years after treatment. NRS=0 or 50%diminution was considered effectively. Results It worked two days on average (zero to seven) after treatment. The NRS score decreased (P<0.05) and the PSS score increased (P<0.05) com-pared with the data before treatment. The effective rate was 100%within six months. The recurrence rate was 11.1%within two years. Sec-ond radiofrequency thermocoagulation treatment still worked for the recurrent patients. No other side effect was observed, except permanent frontal numbness, short-time palpebral edema and ecchymosis. Conclusion Radiofrequency thermocoagulation is effective on refractory su-praorbital neuralgia, and the side effects are tolerable so it is an alternative choice for patients experiencing invalid conservative therapy.

Objective To compare the early therapeutic effects of gentamycin combined with ropivacaine and triamcinolone on trigminal neuralgia.Methods Ninety patients with trigeminal neuralgia were randomly divided into the ropivacaine group and triamcinolone group.The received nerve block peripherally was performed with gentamycin combined with ropivacaine(in the ropivacaine group)or triamcinolone(in the triamcinolone group)respectively.The parameters included pain intensity before and 1 d,3 d,1 week,2 weeks,1 month,2 months and 3 months after treatment,pain relief rate and dosage of carbamazepine of two groups were compared.Results The pain intensity in all the groups decreased at each time point.The value of numeric rating scale(NRS)in the ropivacaine group was significantly less than that in the triamcinolone group at 1 d,1 month,2 months and 3 months.Conclusion Gentamycin combined with ropivacaine is more suitable for trigeminal neuralgia than triamcinolone.

AIM: To explore the pathogenesis of aplastic anemia (AA), we identified the crucial isoform of cyclin D that determine the proliferation of the cord blood CD34~+ cells and observed effects of AA serum on the expression of crucial cyclin D isoform in umbilical cord blood CD34~+ cells. METHODS: The CD34~+ cells were isolated with MIDI-MACS system. The isoforms of cyclin D were detected by RT-PCR and Western blotting. Methylcellulose culture system was used to measure the formation of CFU-GM. The expression level of crucial cyclin D isoform was assayed by RT-PCR and Western blotting after the CD34~+ cells were incubated in AA serum. RESULTS: The crucial cyclin D isoform in CD34~+ cells was cyclin D3. The AA serum inhibited the formation of CFU-GM and down-regulated expression level of the cyclin D3 from the mRNA to protein level, respectively. CONCLUSION: The AA serum inhibits the proliferation of CD34~+ cells and down-regulates level of cyclin D3, this may be one of hematopoiesis inhibition mechanisms in AA.

BACKGROUNDThe optimal ventilated status under total intravenous or inhalation anesthesia in neurosurgical patients with a supratentorial tumor has not been ascertained. The purpose of this study was to intraoperatively compare the effects of moderate hyperventilation on the jugular bulb oxygen saturation (SjO 2 ), cerebral oxygen extraction ratio (O 2 ER), mean arterial blood pressure (MAP), and heart rate (HR) in patients with a supratentorial tumor under different anesthetic regimens.

METHODSTwenty adult patients suffered from supratentorial tumors were randomly assigned to receive a propofol infusion followed by isoflurane anesthesia after a 30-min stabilization period or isoflurane followed by propofol. The patients were randomized to one of the following two treatment sequences: hyperventilation followed by normoventilation or normoventilation followed by hyperventilation during isoflurane or propofol anesthesia, respectively. The ventilation and end-tidal CO 2 tension were maintained at a constant level for 20 min. Radial arterial and jugular bulb catheters were inserted for the blood gas sampling. At the end of each study period, we measured the change in the arterial and jugular bulb blood gases.

RESULTSThe mean value of the jugular bulb oxygen saturation (SjO 2 ) significantly decreased, and the oxygen extraction ratio (O 2 ER) significantly increased under isoflurane or propofol anesthesia during hyperventilation compared with those during normoventilation (SjO 2 : t = -2.728, P = 0.011 or t = -3.504, P = 0.001; O 2 ER: t = 2.484, P = 0.020 or t = 2.892, P = 0.009). The SjO 2 significantly decreased, and the O 2 ER significantly increased under propofol anesthesia compared with those values under isoflurane anesthesia during moderate hyperventilation (SjO 2 : t = -2.769, P = 0.012; O 2 ER: t = 2.719, P = 0.013). In the study, no significant changes in the SjO 2 and the O 2 ER were observed under propofol compared with those values under isoflurane during normoventilation.

CONCLUSIONSOur results suggest that the optimal ventilated status under propofol or isoflurane anesthesia in neurosurgical patients varies. Hyperventilation under propofol anesthesia should be cautiously performed in neurosurgery to maintain an improved balance between the cerebral oxygen supply and demand.

Adolescent ; Adult ; Aged ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Arterial Pressure ; physiology ; Blood Gas Analysis ; Craniotomy ; methods ; Female ; Heart Rate ; physiology ; Humans ; Hyperventilation ; chemically induced ; physiopathology ; Isoflurane ; administration & dosage ; therapeutic use ; Male ; Middle Aged ; Propofol ; administration & dosage ; therapeutic use ; Young Adult

To explore effect of autoantibody on identification of ABO and RhD blood group, the blood samples of 38 patients with autoimmune hemolytic anemia (AIHA) were identified by routine typing and typing after chloroquine elution test as well as PCR. The results showed that out of 38 patients with AIHA, 11 cases (31.6%) of ABO blood group were difficulty typed, indirect antiglobulin test were positive, and contradiction between cells typing and sera typing were observed. 1 case of RhD(-) was mistyped as RhD(+) and anti-D was found in its serum. The blood group of these cases were typed correctly by chloroquine elution test. It is concluded that blood group identification of patients with AIHA can be interfered by autoantibody, and the correct typing for blood group of these patients may be determined by using combination of several methods to ensure safe transfusion.
ABO Blood-Group System ; genetics ; Adolescent ; Adult ; Anemia, Hemolytic, Autoimmune ; blood ; Blood Grouping and Crossmatching ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Rh-Hr Blood-Group System