Objective To introduce three-dimensional management mode to manage the devices in the operating room so as to reduce the risks.Methods A three-dimensional quality control group was established to strengthen the devices management.From three dimensions of thinking,communication and action some measures were proposed including training for standardized operation and incident treatment,improving guidance,sticking warning signs,advocating active report of adverse events,preventive maintenance and etc.Efficacy inspection and continuous improvement were carried out.Results The examination scores,inspection results and active reports of adverse events were significantly different before and after the introduction of three-dimensional management mode.Conclusion Three-dimensional management mode,in which the three dimensions connect to and cycle through each other,makes nursing staffs progressively develop the habit of safe operation in an environment of safety culture.Three-dimensional management mode is a scientific and applicable management method to reduce risks in using the devices in the operating room.

Adult ; Aged ; Cervical Intraepithelial Neoplasia ; pathology ; surgery ; Cervix Uteri ; pathology ; surgery ; Conization ; methods ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; methods ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm, Residual ; pathology ; surgery ; Uterine Cervical Neoplasms ; pathology ; surgery

Objective This study aimed to assess the adherence to guideline-recommended therapies according to risk stratification in the management of acute coronary syndrome(ACS). Methods We analyzed 1,001 consecutive patients admitted with ACS. Patients were stratified using the GRACE risk score into low- and high-predicted risk of mortality at 6 months. We evaluated the use of hospital angiography,revascularization,and guideline-recommended medications between high and low-risk patients. Results High-risk compared to low-risk patients were less likely to underwent coronary angiography and/or revascularization during the hospitalization. The use of hospital-initiated pharmacotherapies was also lower in high-risk patients(P<0.05). Advanced age, increased creatinine level and higher GRACE score were independent predictors for failure to administer evidence-based therapies. Conclusion Patients with ACS at high risk of mortality were paradoxically less likely to undergo revascularization or receive medications according to guidelines. Better adherence to evidence-based therapies in high-risk patients may improve clinical outcome and quality of health care.

Objective To explore the clinical efficacies of laparoscopic distal pancreatectomy (LDP) with laparoscopic splenectomy (LS) for the treatment of malignant tumors in the body and tail of pancreas.Methods The clinical data of 37 patients with malignant tumors in the body and tail of pancreas who were admitted to the Third Affiliated Hospital of Guangzhou Medical University from June 2009 to December 2014 were retrospectively analyzed.LDP with LS was performed on all the patients under general anesthesia.The operation time,volume of intraoperative blood loss,postoperative complications,removal time of postoperative drainage tube,duration of hospital stay and results of pathological examinations were recorded.All the patients were followed up via outpatient examination and telephone interview up to May 2015.Results Thirty-seven patients received successful surgery without conversion to open surgery and perioperative death.Of 37 patients,19 received splenectomy due to splenic artery and vein surrounded by masses of pancreatic body and tail,splenic ischemia after clamping or amputating of splenic artery and vein;11 received splenectomy due to splenic hilum invasion,dense adhesions,unclear boundary and difficulty in preserving spleen;7 received splenectomy due to splenic cystic occupying lesion.The operation time,volume of intraoperative blood loss and removal time of drainage tube were (232 ± 42) minutes,(330 ± 160)mL and (5.0 ± 2.0)days,respectively.Four patients were complicated with pancreatic leakage without obvious discomfort and discharged from hospital with a placement of drainage tube,and then drainage tubes were removed after 2 weeks.The mean duration of postoperative hospital stay was 7.5 days (range,5.0-10.0 days).The results of pathological examination showed that resection margin was negative,moderate and low malignant intraductal papillary mucinous neoplasm (IPMN) was detected in 12 patients,mucinous cystic carcinoma in 9 patients,moderate and low malignant solid pesudopapillary neoplasm (SPN) in 7 patients,pancreatic ductal adenocarcinoma in 4 patients,pancreatic neuroendocrine cancer in 3 patients and acinic cell carcinoma in 2 patients.The number of detecting lymph node was (9 ± 3).All the patients were followed up for a mean time of 9 months (range,3-12 months) without recurrence of tumors.The platelet (PLT) of 37 patients was different levels of increasing.Of 21 patients with PLT ＞ 500 × 109/L,PLT was returned to normal range after aspirin and/ or clopidogrel were taken orally.Conclusion LDP with LS is safe and feasible for malignant tumors in the body and tail of pancreas.

Objective: To observe the inhibitory effects of biotic royal jelly on the ascitic hepatoma cell H22. Methods: Mice bearing H22 tumor were fed on different types of royal jelly: No.1, 2 and 3. Their anti-tumor effects were observed in vivo. The general royal jelly and normal saline were observed as control. Results: Among these biotic royal jelly, the biotic royal jelly No.1 showed obvious tumor-inhibiting and survival-prolonging effects. In addition, it increased the number of WBC and augmented the amount of IL-2 and IFN-γ; the pathological study also indicated the denaturing and necrosis of most tumor cells with nuclei constraining and cell membrane rupturing, and large amount of lymphocytes and plasmacytes infiltrating around the mass. Conclusion: The No.1 biotic royal jelly has obvious anti-tumor effect, and it may take effects by inhibiting or killing tumor cells and improving the immunity of the host.

Objective: To observe the inhibitory effects of biotic royal jelly on the ascitic hepatoma cell H 22 . Methods: Mice bearing H 22 tumor were fed on different types of royal jelly: No.1, 2 and 3. Their anti tumor effects were observed in vivo . The general royal jelly and normal saline were observed as control. Results: Among these biotic royal jelly, the biotic royal jelly No.1 showed obvious tumor inhibiting and survival prolonging effects. In addition, it increased the number of WBC and augmented the amount of IL 2 and IFN ?; the pathological study also indicated the denaturing and necrosis of most tumor cells with nuclei constraining and cell membrane rupturing, and large amount of lymphocytes and plasmacytes infiltrating around the mass. Conclusion: The No.1 biotic royal jelly has obvious anti tumor effect, and it may take effects by inhibiting or killing tumor cells and improving the immunity of the host. [

To investigate the application of meticulous care in intraperitoneal hyperthermic perfusion chemotherapy of gastrointestinal tumors.Methods In our hospital,meticulous care were given to 62 patients during,their intraperitoneal hyperthermic perfusion chemotherapy.Results All the 62 patients completed treatment successfully.There were no complications such as intestinal obstruction,piping around infection and pipeline off,infusion of the drug extravasation,burns and gastrointestinal adverse occurred.And the cognition of patients and families on the intraperitoneal hyperthermic perfusion chemotherapy was improved as well as their satisfaction degree to nursing.Conclusions The meticulous care can reduce the incidence of complications,improve the intraperitoneal hyperthermic perfusion chemotherapy safely,and improve patients 'satisfaction.

Objective To investigate the therapeutic effects of mesenchymal stem cells (MSC) on rat fulminant hepatic failure (FHF). Methods The rat MSC were separated and purified by adherent culture of whole bone marrow cells. The rat FHF models were established by CCl4 intragastric administration.The rats were divided into experimental group (n=20) and model control group (n=20).And the same dose of saline was administered to rats as normal controls (n=8).Dosage of 1.0 × 106 4',6-diamidino-2-phenylindole (DAPI) labeled MSC were transplanted into rats in experimental group and normal control group through caudal veins,and the same dose of saline was given intravenously in model control group.Part of rats in each group were sacrificed after 7 days and 14 days of injection to evaluate the general condition,survival rate,liver function,tumor necrosis factor (TNF)-α level,liver pathology and MSC homing to the liver between experimental group and model control group.Normal distribution data were compared by independent-sample t test and nonnormal distribution data were analyzed by non-parameter test.ResultsAfter 3 days of injection,the generalcondition of experimental group were better than the model control group. After 7 days of injection,there were 15 and 8 survival rats,the survival rates were statistically different between experimental group and model control group (x2 =4.122,P＜0.05).After 7 days and 14 days of injection,the liver function and TNF-α levels were statistically different between experimental group and model control group (both P ＜0.05),and liver pathology improvement in experimental group was more significant than model control group.DAPI labeled cells increased after transplantation in experimental group, whilefewDAPIlabeledcellswere observedinnormalcontrolgroup.ConclusionsMSC can home to liver of FHF rats after MSC allogeneic transplantation through caudal veins,which can improve liver immunity and liver tissue necroinflammation,and facilitate recovery of liver function.Therefore,it is demonstrated that MSC transplantation has obvious therapeutic effect on rat FHF.

Objective To observe the rate-adaptive response of dual sensor pacemakers integrated with activity sensor and minute ventilation sensor.Methods Fifty patients with chronotrepic incompetence were implanted with pacemakers of integrated sensor.The patients with pacemakers implanted were arranged to take upstairs test,downstairs test and tapping test under the monitor of integrated sensor,minute ventilation sensor and activity sensor respectirely.The rate-adaptive responses were tracked down every 15 seconds with remote heart rate monitor.The results were compared with the control group patients with normal sinal chronotropic function(n=15).Results In activity sensor group,pacing rates were significantly higher than the normal control group in downstairs test and tapping test.In minute ventilation sensor group,pacing rates increasement was significantly slower in the beginning of upstairs test.Pacing rates of integrated group were similar to the normal control group in upstairs and downstairs tests.Conclusion The rate-adaptive pacing response of dual sensor integrated with activity sensor and minute ventilation sensor,which is mostly close to the normal chronotropic response,better than that of single sensor.

Objective To evaluate the follow-up results of patients with cervical intraepithelial neoplasia Ⅲ(CIN Ⅲ)after surgical treatment.Methods A retrospective analysis of consecutive patients with CIN Ⅲ after surgical treatment between Jan 1st,1999 and Jun 30 th,2004 was performed.The follow- ups of the patients after surgical treatment were assessed.Results In the follow-up of patients with CINⅢ after surgical treatment,the rate of abnormal cytology was 9.3%.The rate of follow-up was higher in patients with cervical conization than in patients with initial hysterectomy and in patients of the oncological group than of the non-oncological group.The rate of follow-up was lower in patients over 40 years old.There was no difference in the residential areas of the patients.Conclusions Cytological follow-up of patients with CINⅢ after operation is varied.The rate of follow-up is lower in patients over 40 years old,in patients having initial hysterectomy and in patients of the non-oncological group.The rate of follow-up is associated with the knowledge about CIN of both surgeons and patients.