Objective:To explore the combined application effect of failure mode and effect analysis (FMEA) and root cause analysis (RCA) in IV infusion risk management of pediatric outpatient so as to enhance the quality of care and ensure the safety of outpatients.Methods: For this exploration, a special analysis team was established and the flowchart was drawn up, and the potential failure modes were listed by using FMEA. And the RCA was used to analyze and evaluate the key mode in these potential failure modes so as to find the root cause might affect the safety of IV infusion, and then the improved measures were implemented and the effects of new measurement were evaluated. Results:After implemented the improved measures, the risk of top 4 risk priority number (RPN) in intravenous infusion flow decreased obviously. For the transfusion management, patients' satisfaction increased from 78.09% to 95.03% (P<0.05), and nurses' satisfaction increased from 83.79% to 97.80%(P<0.05).Conclusion: The combined application of FMEA and RCA in the IV infusion risk management of pediatric outpatient can effectively reduce the occurrence of risk events, reduce nursing complaints and disputes, and enhance the quality of nursing care.

Objective To observe the clinical effects of self-prescribed Anshen pills in the treatment of female patients with menopausal syndrome . Methods From August 2012 to September 2014, 100 female patients with menopausal syndrome in Tianjin Beichen District Chinese Medicine were randomly divided into control group (50 cases) and observation group (50 cases).The control group received tibolone orally, and the observation group received self-prescribed Anshen pills orally.All treated for 3 months.Modified Kupperman score, self-rating anxiety scale ( SAS) score, self-rating depression scale (SDS) score, Pittsburgh sleep quality index (PSQI) score, menopause-specific quality of life (MENQOL) score, the main clinical symptoms and hormone levels in serum were compared; the adverse reactions were recorded.Results Compared with control group post-treatment, hot flashes and perspiration, insominia improved greatly in observation group.The serum levels of luteinizing hormone ( LH ) in observation group was (28.04 ±3.37)IU/L, which was higher than (24.48 ±6.63)IU/L in control group.PSQI score in observation group was (6.57 ±1.23), which was lower than (8.18 ±1.70) in control group.The incidence of adverse reactions in observation group was 4.0%, which was lower than 18.0% in control group, and there were significant differences between two groups ( P<0.05 ) .Conclusion Self-prescribed Anshen pills is effective and safe for menopausal syndrome.

OBJECTIVEThis study aims to determine the effect of fluoride concentration on the corrosion behavior of cobalt-chromium alloy fabricated by two different technology processes in a simulated oral environment.

METHODSA total of 15 specimens were employed with selective laser melting (SLM) and another 15 for traditional casting (Cast) in cobalt-chromium alloy powders and blocks with the same material composition. The corrosion behavior of the specimens was studied by potentiodynamic polarization test under different oral environments with varying solubilities of fluorine (0, 0.05%, and 0.20% for each) in acid artificial saliva (pH = 5.0). The specimens were soaked in fluorine for 24 h, and the surface microstructure was observed under a field emission scanning electron microscope after immersing the specimens in the test solution at constant temperature.

RESULTSThe corrosion potential (Ecorr) value of the cobalt-chromium alloy cast decreased with increasing fluoride concentration in acidic artificial saliva. The Ecorr, Icorr, and Rp values of the cobalt-chromium alloy fabricated by two different technology processes changed significantly when the fluoride concentration was 0.20% (P < 0.05). The Ecorr, Icorr, and Rp values of the cobalt-chromium alloy fabricated by two different technology processes exhibited a statistically significant difference. The Icorr value of the cobalt-chromium alloy cast was higher than that in the SLM group cobalt-chromium alloy when the fluoride concentration was 0.20% (P < 0.05). The Ecorr, tRp alues of the cobalt-chromium alloy cast were lower htan those of the SLM group cobalt-chromium alloy when the fluoride concentration was 0.20% (P< 0 .05).

CONCLUSIONFluoride ions adversely affected the corrosion resistance of the cobalt-chromium alloy fabricated by two different technology processes. The corrosion resistance of the cobalt-chromium alloy cast was worse than that of the SLM group cobalt-chromium alloy when the fluoride concentration was 0.20%.

Objective To investigate nursing interns’knowledge and attitude towards needle stick injury before clinical practice.Methods In 20-23 June,2015,nursing interns who were about to start clinical practice in a hospi-tal were investigated,nursing interns’knowledge and attitude towards needle stick injury were surveyed through questionnaire.Results A total of 350 questionnaires were distributed,324 (92.57%)responded questionnaires were available.40(12.35%)questionnaires were responded by male interns,and 284(87.65%)were by female in-terns;34(10.49%)interns had bachelor degree;the mean age of interns were (20.83 + 1 .24)years old.The correct answer rates about questions related to injury occurring during needle recapping and wearing gloves were low (about 60%).About 70% of the interns gave the correct answers to questions about hepatitis B infection due to needle stick injury following hepatitis B vaccination,as well as medication after injury.Score for individual question about attitude towards needle stick injury was ≤3,the major related problems were susceptibility of blood borne diseases and recapping needles.Conclusion Needle stick injury-related knowledge and attitude among nursing interns is inadequate,including recapping needles,timely report,susceptible to infectious diseases,and so on.It is necessary for schools and teaching hospitals to strengthen the education about occupational protection among nursing interns, so as to improve the attitude and ability of professional protection.

Objective To study the effect of TCM five-tone therapy on chronic fatigue syndrome(CFS).Methods Fifty nine CFS patients were divided into the treatment group(n=30)and the control group(n=29),which received TCM five-tone therapy and common music therapy,respectively for 3 months.Both groups were assessed with fatigue Scale-14,depression status inventory and visual analogue scale.Result After treatment,the treatment group was scored lower than the control group in FS-14,DSI and VAS(all P<0.05).Conclusion TCM five-tone therapy may be more effective in decreasing the CFS patients with fatigue and depression and alleviating their pain symptoms.

AIM To explore the effects of Xuebijing Injection (Carthami Flos,Salviae miltiorrhizae Radix et Rhizoma,Paeoniae Radix Rubra,etc.) on serum CRP,TNF-α and IL-6 levels in patients with severe acute organophosphorus pesticide poisoning (AOPP).METHODS Seventy-two cases of patients with AOPP treated from Jan 2014 to Mar 2016 in the emergency department of our hospital were randomly divided into two groups,the control group treated with atropine,pralidoxime chloride and conventional treatment,and the observation group combined with Xuebijing Injection.The dynamic changes of serum CRP,TNF-α and IL-6 levels,and clinical curative effects were compared between the two groups.RESULTS The serum CRP,TNF-α and IL-6 levels in the two groups were decreased in turn before the treatment,at the 3rd,7th days after the treatment,and the serum CRP,TNF-α and IL-6 levels in the observation group were significantly lower than those in the control group;the dosage of atropine,time of cholinesterase activity recovered 60％ and hospital stay in the observation group were significantly less than those in the control group;the rebound rate of the observation group was lower than that of the control group.The acute respiratory distress syndrome (ARDS) rate in the observation group was significantly lower than that in the control group.All the differences had statistical significances (P ＜ 0.05).CONCLUSION Xuebijing Injection can effectively inhibit the inflammatory response,reduce the incidence of complications,shorten the course,and improve the clinical efficacy in the treatment of patients with AOPP.

Background:It was demonstrated that vitamin D has extensive biological effects,and evidence exists on association between vitamin D and a variety of immune mediated diseases such as inflammatory bowel disease. Aims:To investigate the relationship between serum level of 25-hydroxyvitamin D(25OHD)and disease activity and quality of life in patients with ulcerative colitis( UC). Methods:Serum level of 25OHD was detected by electrochemiluminescence in 50 outpatients/inpatients with UC from Oct. 2015 to Mar. 2016 at the Anhui Provincial Hospital;35 healthy subjects were served as normal controls. CRP,ESR and PLT were determined by routine laboratory tests in UC patients. Disease activity of UC was assessed by improved Mayo score,and Chinese version IBD questionnaire( IBDQ)was employed to assess quality of life. Results:Vitamin D deficiency defined as serum 25OHD ﹤20 ng/mL was detected in 68. 0% of the UC patients. The mean value of serum 25OHD was significantly lower in UC group than in normal control group[(16. 73 ± 8. 83)ng/mL vs.(19. 84 ± 4. 56)ng/mL,P﹤0. 05]. When patients were stratified with disease activity,serum level of 25OHD decreased in the order of remission,mild,moderate and severe active stage(P ﹤0. 05). In UC patients with vitamin D deficiency,the value of CRP,ESR and PLT were significantly increased(P all ﹤0. 05)and the overall score of IBDQ and scores of four dimensions of IBDQ referring to bowel symptom,systemic symptom,emotional function and social function were significantly decreased(P all ﹤0. 05). Spearman and Pearson correlation coefficients analyses showed that serum level of 25OHD was negatively correlated with Mayo score,CRP,ESR and PLT(P all ﹤0. 05),and positively correlated with scores of IBDQ,including overall score and four dimensional scores in UC group( P all ﹤0. 05 ). Conclusions:Vitamin D deficiency occurs frequently in patients with UC and might have a negative impact on disease activity and quality of life.

. Conclusions Two multiplex RT-PCR assays show high consistency with common RT-PCR. The multiplex RT-PCR assays were initially established.

Objective To explore the effect of health belief model on compliance behavior of patients with PICC(peripherally inserted central catheter).Methods According to admission order,75 cases of PICC were divided into control group(n=36)and observation group(n=39).Patients in the control group received conventional health education and regular visits after discharge and besides the regular methods,patients in the observation group were intervened by health belief model for the compliance behavior.All patients of two groups were investigated with self-designed scale for compliance behavior.Result The compliance behavior of the observation group was better than that of control group with significant difference(P<0.05).Conclusion The health belief model of education can improve the compliance behavior of PICC patients after discharge from hospital.

Objective To develop an ultrasmall superparamagnetic iron oxide(USPIO)based MR probe targeting CD40 mutant and investigate its biological and chemical properties and its targeting effect on ovarian cancer cells in vitro.Methods To prepare immunologically competent probe,the monoclonal antibody was conjugated with USPIO particles modified by DMSA based on chemical crosslinking method.The USPIO labeled anti-human CD40 mutant monoclonal antibody 5H6(5H6-USPIO)was the experimental probe,and the USPIO labeled anti-human CD40 monoclonal antibody 5C11(5C11-USPIO)and USPIO served as control agents.The flow cytometry,confocal microscopy and Prussian blue staining were employed to assess the magnetic performance and analyze its bioactivity of the probe.The probe's cell MR imaging in vitro was carried out using ovarian caner cells(HO8910)with high CD40 mutant expression.The analysis of signal data of different groups was conducted by using one-way ANOVA andLSD test.The probe's effect on ovarian caner cells' growth was measured by CCK-8 kit.Results The stable molecular probe carrying nanoparticles and CD40 mutant antibody was built and purified successfully.The probe had similar magnetic property compared with original USPIO.Immunofluorescence and Prussian blue staining confirmed that the molecular probe could recognize CD40 mutant on ovarian cancer cells(HO8910)with high specificity.The probe had no effect on the growth of HO8910 cells.MR cell imaging in vitro showed that the value of T2 and T2 * decreased significantly after the probe binding with HO8910 cells and T2WI became darker than control groups.The T2 and T2* relaxation time of 5H6-USPIO group was(40.05 ± 1.62)ms and(3.08 ± 0.11)ms,respectively.The T2 and T2 * relaxation time of 5H6-USPIO group was shorter than 5C11-USPIO [(85.38 ± 4.74)and(11.82 ± 1.00)ms,respectively]and USPIO[(91.62 ± 3.35)and(13.60 ± 1.92)ms,respectively]groups with statistical significance(F =196.29,60.73,P ＜0.01).The difference of T2 and T2* relaxation time between 5C11-USPIO and USPIO groups showed no statistical significance (P ＞0.05).Conclusions CD40 mutant antibody can conjugate with ultrasmall superparamagnetic iron oxide particles to form MR molecular probe using chemical crosslinking method.The probe has good magnetic characters and high bioactivity.The probe can specifically bind with HO8910 cells.