Objective To explore the effect of PDCA circulation on the effective utilization of the disposable articles in the operating room.Methods 9,362 aseptic articles for 446 operations in the departments of general surgery and hepatobiliary surgery during January to May 2012 were put in the pre-experiment group,in which PDCA circulation was not used.Another 11,973 articles for 501 operations in the same departments during June to November 2012 were set as the post-experiment group,in which PDCA circulation was used.The two groups were compared in terms of the effective utilization rate and the degree of doctor’s satisfaction with the nurses in the operation room.Result After the implementation of PDCA circulation,the effective utilization rate and the degree of doctor’s satisfaction were both significantly higher than before the implementation(both P<0.05).Conclusion PDCA circulation for the management of sterile disposable articles in the operation room may effectively improve the utilization rate of disposable articles, reduce wasting of articles and safe resources.

Chinese materia medica(CMM) industry is one of the most national identity in China′s industries.According to the development situation in recent years,putting forward some reasonable ideas will promote better and faster development of the CMM industry.In this paper,through the literature review combined with CMM industry development status,the current structure of CMM industry was analyzed.And based on the concept of the industrial chain,the CMM industry chain structure was analyzed and described.The proposal of building a harmonious CMM industry chain was put forward clearly,which will conform to the requirements of the CMM industry development.Above all,this article has provided some constructive ideas for future development of CMM industry.

Objective: To investigate the characteristics of acoustic impedance test and its diagnostic role for occupational noise induced deafness, in order to provide an objective basis for the differential diagnosis of occupational noise induced deafness. Methods: A retrospective study was conducted to investigate the cases on the diagnosis of occupational noise-induced deafness in Guangdong province hospital for occupational disease prevention and treatment from January 2016 to January 2017. A total of 198 cases (396 ears) were divided into occupation disease group and non occupation disease group based on the diagnostic criteria of occupational noise deafness in 2014 edition, acoustic conductivity test results of two groups were compared including tympanograms types, external auditory canal volume, tympanic pressure, static compliance and slope. Results: In the occupational disease group, 204 ears were found to have 187 ears (91.67%) of type A, which were significantly higher than those in the non occupational disease group 143/192 (74.48%) , the difference was statistically significant (χ²=21.038, P<0.01). Detection of Ad or As type, occupation disease group in other type were 16/204 (7.84%) , 3/204 (1.47%) , were lower than Ad or As type of occupation disease group (15.63%) , other type (9.38%) , the differences were statistically significant[ (χ²=5.834, P<0.05) , (χ²=12.306, P<0.01) ]. Occupation disease group canal volume average (1.68±0.39) ml higher than that of non occupation disease group (1.57±0.47) ml, the difference was statistically significant (t=2.756, P<0.01) ; occupation disease group mean static compliance (1.06±0.82) ml higher than that of non occupation disease group (0.89±0.64) ml. The difference was statistically singificant (t=2.59, P<0.01) . Conclusion We observed that acoustic impedance test had obvious auxiliary function in the differential diagnosis of occupational noise induced deafness, More than 90% of the confirmed cases showed an A-form tympanograms, it is one of the objective examination methods which can be used in the differential diagnosis of pseudo deafness.

Objective: Study of the results and the degree on occupational noise-induced deafness in-to the different high frequency hearing threshold weighted value, in order to provide theoretical basis for the re-vision of diagnostic criteria on occupational noise-induced deafness. Methods: A retrospective study was con-ducted to investigate the cases on the diagnosis of occupational noise-induced deafness in Guangdong province hospital for occupational disease prevention and treatment from January 2016 to January 2017. Based on the re-sults of the 3 hearing test for each test interval greater than 3 days in the hospital, the best threshold of each frequency was obtained, and based on the diagnostic criteria of occupational noise deafness in 2007 edition, Chi square test, t test and variance analysis were used to measure SPSS21.0 data, their differences are tested among the means of speech frequency and the high frequency weighted value into different age group, noise ex-posure group, and diagnostic classification between different dimensions. Results: 1. There were totally 168 cases in accordance with the study plan, male 154 cases, female 14 cases, the average age was 41.18 ±6.07 years old. 2. The diagnosis rate was increased into the weighted value of different high frequency than the mean value of pure speech frequency, the weighted 4 kHz frequency increased by 13.69% (χ²=9.880, P=0.002) , 6 kHz increased by 15.47% (χ²=9.985, P=0.002) and 4 kHz+6 kHz increased by15.47% (χ²=9.985, P=0.002) , the difference was statistically significant. The diagnostic rate of different high threshold had no obvious differ-ence between the genders. 3. The age groups were divided into less than or equal to 40years old group (A group) and 40-50 years old group (group B) , there were higher the diagnostic rate between high frequency weighted 4 kHz (A group χ²=3.380, P=0.050; B group χ²=4.054, P=0.032) , weighted 6 kHz (A group χ²=6.362, P=0.012; B group χ²=4.054, P=0.032) , high frequency weighted 4 kHz+6 kHz (A group χ²=6.362, P=0.012; B group χ²=4.054, P=0.032) than those of speech frequency average value in the same group on oc-cupational noise-induced deafness diagnosis rate, the difference was statistically significant. There was no sig-nificant difference between age groups (χ²=2.265, P=0.944) . 4. The better ear's mean value of pure speech fre-quency and the weighted values into different high frequency of working years on each group were compared, working years more than 10 years group was significantly higher than that of average thresholds of each frequen-cy band in 3-5 group (F=2.271, P=0.001) , 6-10 group (F=1.563, P=0.046) , the difference was statistically significant. The different high frequency weighted values were higher than those of the mean value of pure speech frequency, and the high frequency weighted 4 kHz+6 kHz had the highest frequency difference, with an average increase of 2.83 dB. 5. The diagnostic rate into weighted different high frequency was higher in the mild, moderate and severe grades than in the pure speech frequency. In the comparison of diagnosis for mild occupational noise-induced deafness, in addition to the weighted 3 kHz high frequency (χ²=3.117, P=0.077) had no significant difference, the weighted 4 kHz (χ²=10.835, P=0.001) , 6 kHz (χ²=9.985, P=0.002) , 3 kHz+4 kHz (χ²=6.315, P=0.012) , 3 kHz+6 kHz (χ²=6.315, P=0.012) , 4 kHz+6 kHz (χ²=9.985, P=0.002) , 3 kHz+4 kHz+6 kHz (χ²=7.667, P=0.002) were significantly higher than the diagnosis rate of the mean value of pure speech frequency. There was no significant difference between the two groups in the moderate and se-vere grades (P>0.05) . Conclusion Bring into different high frequency hearing threshold weighted value in-creases the diagnostic rate of occupational noise-induced deafness, the weighted 4 kHz, 6 kHz and 4 kHz+ 6 kHz high frequency value affects the result greatly, and the weighted 4 kHz+6 kHz high frequency hearing threshold value is maximum the effect on occupational noise-induced deafness diagnosis.

OBJECTIVE: To analyze the changes of finger skin temperature in cold provocation test( CPT) in workers with vibration white finger( VWF). METHODS: A total of 245 male workers engaged in hand arm vibration operation was selected as study subjects using random number table method. All subjects were divided into VWF group( 73 persons) and control group( 172 persons). CPT( 10 ℃,10 min) was performed and the skin temperature of 6 fingers( index finger,middle finger and ring finger of both hands) was measured at pre-CPT adaptation period( 0,10,20,30 min) and after CPT period( 0,5,10,15,20,25,30 min). RESULTS: The effect of interaction between grouping and observe time was statistically significant on finger skin temperature( P < 0. 01). In the pre-CPT adaptation period,there was no statistically significant difference on skin temperature between 10 and 30 min time point in the two groups( P > 0. 05). After CPT,the fingers skin temperature of VWF group was lower than that of control group at 5 min time point( P < 0. 05),but there were no statistically significant differences on fingers skin temperature of other time points between the two groups( P > 0. 05).In both groups,the finger skin temperature at 0 min time point after CPT were lower than other time points in the same group( P < 0. 05),and the finger skin temperature increased with time( P < 0. 01). However,the finger skin temperature at 30 min after CPT did not restore to that at 30 min time point of pre-CPT. Except the VWF group,the abnormal rewarming temperature at 5 min time point after CPT of left index finger,the right index finger and the right ring finger were higher than that of the control group( 72. 6% vs 56. 4%,75. 3% vs 57. 6%,86. 3% vs 65. 1%,P < 0. 05),but there were no statistically significant differences on the abnormal rewarming temperature at 10,30 min time points of the six fingers in the two groups( P > 0. 05). There were no statistically significant differences on the detection rate of abnormal rewarming temperature between left index finger and the right index finger,or the right index finger and the right ring finger in the VWF group( 72. 6% vs 75. 3%,75. 3% vs 86. 3%,P > 0. 05). CONCLUSION: When CPT( 10 ℃,10 min) was performed in workers engaged in hand arm vibration operation,it is recommended to measure the finger skin temperature of index finger,and adaptation time before CPT can be adjusted to 10 min.

Objective: To systematically analyze the risk factors for urinary tract infection (UTI) in children with primary nephrotic syndrome (PNS), in order to provide scientific evidence for clinical prevention. Methods: Eight databases including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, WanFang Database, Chinese Science and Technology Periodical Database and Chinese Biological Medical Literature Database were retrieved for the case-control studies on PNS complicated with UTI in children.According to the inclusion and exclusion criteria, eligible studies were selected for meta-analysis by using RevMan 5.3 software. Results: Finally, 12 case-control studies were included, 917 children in the case group and 2 784 children in the control group.Compared with children without UTI, statistically significant difference existed in children with UTI of elevated 24-hour urine protein [standardized mean difference (SMD)=0.45, 95% CI: 0.02-0.88], decreased serum albumin (SMD=-1.06, 95%CI: -1.14--0.97), elevated serum cholesterol [weighted mean difference (MD)=2.28, 95%CI: 1.61-2.95], elevated serum low density lipoprotein (SMD=0.57, 95%CI: 0.37-0.77), decreased plasma IgG (SMD=-0.76, 95%CI: -0.94 to-0.58), elevated plasma IgM (MD=0.28, 95%CI: 0.11-0.46), high-dose hormone (MD=0.75, 95%CI: 0.58-0.92), and long time hormone use[<15 d odds ratio (OR)=-0.20, 95%CI: 0.10-0.42; ≥15 d OR=5.00, 95%CI: 2.38-10.50]. Conclusions Massive proteinuria, hypoalbuminaemia, hypercholesterolemia, high level of low density lipoprotein, decreased plasma IgG, high-dose hormone and long time hormone use are risk factors for UTI in children with PNS.

OBJECTIVE: To explore the association of interaction of noise exposure and superoxide dismutase( SOD) gene polymorphism on the susceptibility of occupational noise-induced hearing loss( ONHL) in Chinese Han population.METHODS: A simple random sampling method was used to select 2 400 Han workers as study subjects.These workers were exposed to 75.0-120.0 dB( A) of normalized continuous A-weighted sound with pressure level equivalent to a 40 hworking-week( L_(EX,W)) in Guangzhou City.A model method was set up to define 201 sensitive workers( sensitive group)and 202 resistant workers( resistant group) by combining results with hearing pure tone threshold test and the cumulative noise exposure( CNE).The genomic DNA was extracted from peripheral blood cells.The single nucleotide polymorphisms analysis of SOD was carried out by using the TaqMan probe with chemical fluorescence allelic identification test.Binary logistic regression method was used to analyze the interaction of noise exposure and SOD.RESULTS: After adjusting confounding factors such as gender,heavy metal exposure,dust exposure and high temperature exposure,the risk for ONHL in individuals interactively carry rs2040724 AG or GG and rs4880( CC + CT) was significantly higher than that in individuals interactively carry rs2040724 AA and rs4880 TT( P < 0.05).The risk for ONHL in individuals interactively carry rs10432782 GT or GG and rs4880( CC + CT) was significantly higher than that in individuals interactively carry rs10432782 TT and rs4880 TT( P < 0.05).The risk for ONHL in individuals exposed to L_(EX,W)≥85 dB( A) and interactively carried with rs2040724 GG and rs4880( CC + CT) was significantly higher than that in individuals exposed to L_(EX,W)< 85 dB( A) and interactively carry rs2040724 AA and rs4880 TT( P < 0.01).The risk for ONHL in individuals exposed to L_(EX,W)≥85 dB( A) and interactively carry rs10432782 GT or GG and rs4880( CC + CT) was significantly higher than that in individuals exposed to L_(EX,W)< 85 dB( A) and interactively carry r10432782 TT and rs4880 TT( P < 0.05).CONCLUSION: In Chinese Han population,noise exposure intensity and SOD1( rs2040724,rs10432782),SOD2( rs4880)gene polymorphism had interacting effects on ONHL susceptibility.

Humans ; Hypertension/therapy* ; Publications ; Research Design

OBJECTIVE: To explore the molecular mechanism underlying 1,2-dichloroethane(1,2-DCE) induced apoptosis by screening differentially expressed proteins in human astrocytes( HAs). METHODS: HAs were cultured in complete medium with 1,2-DCE at various concentrations of 0-80 or 0-40 mmol/L. After 24 hours,apoptosis of HAs was evaluated using flow cytometry and staining with annexin Ⅴ-fluoresce in isothiocyanate and propidium iodide. An AAH-APO-1-2 protein chip was used to screen differentially expressed proteins and quantitative real-time polymease chain reaction(qRT-PCR) was used to verify related differentially expressed genes(DEGs). RESULTS: At 1,2-DCE concentrations of0-80 mmol/L,the total apoptosis rate of HAs increased with 1,2-DCE concentrations in a dose-dependent manner( P <0. 01). Seven different kinds of proteins were screened out by apoptotic protein chip. Among them,the expression of insulin-like growth factor-binding protein( IGFBP)-1,IGFBP-4 and cytochrome C( Cyto C) were up-regulated,while the expression of P27,cysteine aspartic acid specific protease-3( Caspase-3),B-cell lymphoma-2 interacting mediator of cell death( BIM) and BH3 interacting domain death agonist( BID) were down-regulated compared with the control group. The result of DEGs verified by qRT-PCR showed that the expression of mRNA of IGFBP-1,IGFBP-4 and Cyto C at 1,2-DCE concentrations of 40 mmol/L was up-regulated. This result was in consistent with the trend of target expression in the protein chip. The mRNA expression of Caspase-3,BIM and BID was also up-regulated. CONCLUSION: 1,2-DCE induces apoptosis of HAs through mitochondrial pathway.

OBJECTIVE: To summarize and analyze the diagnostic ideas of new occupational lung tumors in Guangdong Province.METHODS: According to the Law of the People′s Republic of China on the Prevention and Control of Occupational Disease and the GBZ 94-2002 Diagnostic Criteria of Occupational Cancer, the key diagnostic points of 6 new occupational lung tumors diagnosed in Guangdong Province from 2010 to 2011 were analyzed. RESULTS: There were 9 cases of 6 new kinds of new occupational tumors were diagnosed in Guangdong Province in 2010-2011. The cases included 3 occupational lung cancer of coke oven workers, 2 occupational lung cancer caused by asbestos, 1 occupational mesothelioma caused by asbestos, 1 occupational lung cancer caused by arsenate, 1 occupational lung cancer caused by chromate salt, and 1 occupational lung cancer caused by asphalt. During the process, the diagnosis was based on the principles of the comprehensive analysis and the attribution diagnosis, combined with occupational history, occupational disease hazard exposure history, clinical data and auxiliary examination results. If the patients were diagnosed with a primary tumor, the patients′ exposure history to occupational carcinogens should be tracked, traced and confirmed, and the diagnosis should be confirmed by referring to the list of occupational carcinogens and literature reports of the International Labor Organization, and not limited to only the personnel in a particular industry. CONCLUSION: During the diagnostic process of occupational tumors, attention should be paid to confirm the exposure history of occupational carcinogen. The key is to determine the exposure of corresponding occupational carcinogen, the route and the time of exposure and the incubation period.