Objective To discuss the application of prospective quality management in quality control of indwelling needle .Methods Twelve wards carried out the nurse grading management and set up prospective quality control management system , which was charged by a three-grading system of responsible nurse-responsible nursing group leader-head nurse .The intravenous indwelling needle was intervened under the consult of the professional guidance .The usage and maintenance of the indwelling needle before and after applying the prospective quality control management system were compared .Results The usage of the indwelling needle was decreased from 53.6%to 31.3%.The difference was significant (χ2 =45.099,P<0.01).The incidence of bad conditions of the maintenance was significantly decreased (P<0.01).Conclusions Every level of nursing staff is responsible for the prospective quality control management system , which can improve the participation of quality control and shorten the management extent .The system is oriented from clinical practical problems , so as to improve the control efficiency , and the usage and maintenance quality has been improved obviously .

Objective:To investigate the association of the difference between 2-hour postprandial blood glucose and fasting blood glucose with non-alcoholic fatty liver disease(NAFLD)in elderly patients with type 2 diabetes(T2DM).Methods:A total of 953 patients aged≥65 years with T2DM hospitalized in the Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People's Hospital from January 2007 to June 2009, with complete clinical data, were selected in this retrospective study.The absolute value of the difference between 2-hour postprandial blood glucose and fasting blood glucose was recorded as the blood glucose difference.According to the tertiles of the blood glucose difference, patients were divided into three groups including the first tertile(n=317, blood glucose difference<4.12 mmol/L), the second tertile(n=320, blood glucose difference between 4.12-7.69 mmol/L), and the third tertile(n=316, blood glucose difference≥7.69 mmol/L). Detailed clinical data of the patients were collected, and clinical characteristics and the prevalence of NAFLD were compared among the three groups.The correlation between the blood glucose difference and NAFLD was analyzed.Results:From the first tertile to the third tertile, there appeared to be increased proportions of patients using metformin( χ2=9.581, P=0.008), higher waist-to-hip ratios( F=3.663, P=0.026), increased 24 h uric acid excretion( χ2=6.241, P=0.044), increased alanine aminotransferase levels( χ2=22.361, P<0.001), increased γ-glutamyl transpeptidase levels( χ2=17.681, P<0.001)and increased 2h postprandial blood glucose levels( χ2=579.315, P<0.001), with significant statistical differences in the waist circumference( F=4.723, P=0.009), body mass index( F=5.811, P=0.003), fasting C-peptide levels( χ2=9.442, P=0.009), 2h postprandial C-peptide levels( χ2=17.599, P<0.001)and glycosylated hemoglobin A1c( F=30.836, P<0.001)between the three groups and the prevalence of NAFLD also grew steadily(24.0%, n=76 vs. 33.1%, n=107 vs. 36.7%, n=116, χ2=12.712, P<0.01). After adjusting for other variables, multivariate logistic regression analysis showed that the blood glucose difference was correlated with NAFLD in elderly patients with T2DM( OR=1.396, Wald χ2=0.002, P<0.01). Conclusions:Elderly T2DM patients with greater blood glucose differences have more severe metabolic disorders and a higher prevalence of NAFLD.An increase in blood glucose differences is an independent risk factor for NAFLD in elderly T2DM patients.

Human oral cavity is colonized by various microbial communities which play an important role in the initiation and progression of periodontitis. However, it is still not clear how these microbial communities mediate the disease. With the rise of metagenomics research, polymicrobial synergy and dysbiosis (PSD) model, a new periodontitis pathogenesis mechanism, was proposed. The importance of the microbial communities acting as a whole system in the development of periodontitis is gradually recognized. Host susceptibility, as another key factor in the initiation of the disease, is vital in PSD model. This article reviews the mechanisms of the PSD model and its research progress in periodontitis as well as some other diseases and briefly highlights the positive significance in terms of prevention and treatment of periodontitis in order to provide insights and perspectives for the future periodontal researches.