Objective To evaluate the efficacy of traditional Chinese medicine which eliminating necrotic tissues and promoting granulation on pressure ulcer of Ⅲ to Ⅳstage using Meta analysis.Methods RCTstudies of therapy of eliminating necrotic tissues and promoting granulation traditional Chinese medicine for stage Ⅲ～Ⅳ pressure ulcer were searched,in which the control groups used routine methods,while the experimental groups adopted necrotic tissues and promoting granulation traditional Chinese medicine.Two reviewers assessed the documents'quality separately and completed data extraction.The statistical analysis was performed using the Cochrance collaborations' Rev Man 5.1 software.Results The cure rates for pressure ulcers of the experimental groups were higher than the control groups.The time of recovery of the experimental groups were shorter than the controls.The dressing change frequency of the experimental groups was less than the controls.Conclusions Traditional Chinese medicines which eliminating necrotic tissues and promoting granulation can significantly improve the cure rate,shorten the therapeutic time and reduce the frequency of dressing change.

BACKGROUND: Constipation, especially that caused by spleen insufficiency in transportation, often not responses to common purgatives, however,the therapy to strengthen the spleen and regulate qi so as to promote transportation and dredge stasis may be an ideal way to resolve the problem.OBJECTIVE: To investigate the effect of zhizhu decoction, a classic famous prescription, on gastric motility of mice with spleen insufficiency constipationDESIGN: A randomized controlled trial.SETTING: Department of Traditional Chinese Medicine (TCM) of Guangdong Medical College and Spleen-stomach Institute of Guangzhou University of Traditional Chinese Medicine.MATERIALS: The experiment was completed from June to December2002 at Spleen-stomach Institute of Guangzhou University of Traditional Chinese Medicine. Totally 328 NIH mice of general grade were chosen.METHODS: Mouse models with spleen insufficiency constipation were set up by irregular diet and overstrain combined with water deprivation. The influence of zhizhu decoction in large, middle and small doses on defecation in both spleen insufficiency mice and normal mice was investigated, taking Chinese patent drug bianmi tong (bowel-relaxing) as a positive control. In observation of normal mice defecation, there were five groups of large dose,middle dose and small dose of zhizhu decoction, bianmi tong and normal control. In observation of defecation of spleen insufficiency constipation mice, there were six groups: the above five and a natural recovering. In observation of loading mice trial, besides the above five groups, there was an atropine group. After administration, the time when the mice first defecated dark stool, the number of stool grains and the stool quantity were observe;and the percentage of small intestine advance was calculated.MAIN OUTCOME MEASURES: [1] Observation of the effect of zhizhu decoction on the defecation in both normal and spleen insufficiency mice.[2] The influence of zhizhu decoction on bowel advance in both normal and atropine loading miceRESULTS: Totally 328 mice were involved in the trial and 319 entered into the final result analysis, the other 9 died because of mistake in administration by gavage. The effect of zhizhu decoction on the defecation: [1] For normal mice, compared with the distilled group, in the zhizhu decoction groups of various doses the time when the mice first defecated dark stool was obviously reduced, and the number of stool grains and stool quantity were obviously increased, but the effect in the large and middle dose groups was best. [2] Compared with the normal group, in the model group the time when the mice first defecated dark stool was obviously increased, and the number of stool grains and stool quantity were obviously decreased. Zhizhu decoction in large and middle doses could obviously reduce the time when the mice first defecated dark stool, and increase the number of stool grains and stool quantity, the effect was better than that of the control drug bianmi tong. The influence ofzhizhu decoction on intestinal advance in mice: [1]Zhizhu decoction in various doses could obviously increase the rate of intestinal advance compared with distilled water group for normal mice. [2]Adding atropine load could reduce the rate of intestinal advance compared with the normal control group, and the percentage in all zhizhu decoction groups was obviously increased compared with the atropine group.CONCLUSION: Zhizhu decoction can reduce the time when the mice first defecated dark stool, increase the number of stool grains and stool quantity were obviously increased to both normal mice and mice with spleen insufficiency mice; it can also increase the intestinal advance rate in normal mice, and had a good antagonism against the inhibition of atropine to intestinal advance. In the trials the effect of zhizhu decoction in large and middle doses was more obvious, with a certain dose-effect relationship, the effect was better than that of the control drug bianmi tong.

Objective To develop a kind of new machine for making animal model for pressure ulcer,and inspect its effect through experiments,in order to lay the foundation for the research of pressure ulcer experiments on animals.Methods This study developed the machine after reviewing the domestic and foreign literature,making full use of the existing experimental platform of our university.Then 55 Sprague Dawley(SD) rats were selected,after anesthesia and the skin preparation,the researchers imposed certain pressure with 70 mmHg/cm2 (1 mmHg=0.133 kPa) on the skin and muscle tissue on the inner left thigh of SD rats by using self-designed machine,pressing for 2 h,then reperfusion for 30 min,3 times a day,a total of 7 days.Results The authors developed a kind of new machine for making animal model for pressure ulcer,and successfully prepared Ⅲ phase pressure ulcers model in SD rats with success rate of 98.2％(54/55).Conclusion This machine can prepare Ⅲ phase pressure ulcers model on animals,it's easy to use and efficient,it can be used for researches in the field of prevention and cure of pressure ulcers.

Objective To assess the effectiveness and safety of heat moisture exchangers (HMEs) on the artificial airway humid-ification in the mechanically ventilated patients .Methods The related literature in the Cochrane Library ,PubMed ,Embase ,CNKI , VIP ,WanFang database and CBM from the establishment to March 2012 were retrieved ,then included the randomized controlled trial(RCT) and quasi-RCT on the effect of HMEs for the artificial airway humidification in the mechanically ventilated patients were performed the meta analysis by using RevMan 5 .1 .2 software .Results 19 RCT were included(involving 2 960 patients) , which were the random parallel controlled trials .The meta analysis results showed that HMEs could not reduce the incidence rate of ventilator-associated pneumonia(VAP)(RR=0 .78 ,95% CI 0 .61-1 .01 ,P=0 .06) ,also could not decrease the hospitalization mor-tality(RR=0 .94 ,95% CI 0 .83-1 .08 ,P=0 .40) ,the length of ICU stay(MD= -0 .32 ,95% CI -3 .13 -2 .50 ,P=0 .82) and the occurrence rate of catheter occlusion (RR=0 .65 ,95% CI 0 .22 -1 .93 ,P= 0 .44) ,the differences between the two groups had no statistical significance .But 5 RCT reported that using HMEs could reduce the patient′s costs .Conclusion HMEs can not reduce the incidence rate of VAP ,mortality ,length of ICU stay ,occurrence rate of airway occlusion ,but can cut down the patient′s cost . Due to the risk of bias existing in all included RCT and the low quality of the obtained evidences ,more strictly designed and imple-mented RCTs are needed to further verify thse evidences .

Objective To systematically analyze and evaluate the intervention effect of foreign and domestic research about needlestick injuries in medical staffs and provide the basis for reducing the rate of occupational exposure of medical staffs.Methods The intervention study of needlestick injuries in medical staffs between 1981 and 2013 were collected in CNKI,VIP,Wanfang and PubMed databases,Metaanalysis was conducted for the included studies by RevMan5.2 software.According to I2 and P value heterogeneity was determined,choose a fixed or random effect model to analyze and merge the data to measure the effect of the intervention by OR and 95％ confidence intervals (C I).Results The total of included studies was 19,the number of the intervention group and the control group was 20 592 and 19 855,the OR and 95％ CI of intervention effect as shown below:comprehensive intervention OR=0.40,CI 95％ (0.27～0.59),education and training OR=0.24,CI 95％ (0.11～0.55),safety management OR=0.09,CI 95％ (0.06～0.13),engineering intervention OR=0.30,CI 95％ (0.16～0.55),safe operation OR=0.15,CI 95％ (0.09～0.26).The intervention group and the control group were statistically significant on reducing the incidence of needlestick injuries.Conclusions Education and training,safety management,engineering intervention,and safe operation can reduce the incidence of needlestick injuries,improve the quality of life of medical staffs.

Objective To explore the effect of cognitive behavioral intervention on quality of life and distress of cancer patients. Methods The research was a random control study, and computer randomized grouping, the experimental group and control group contained 64 cases, 66 cases, respectively. The control group only accepted health education, while experimental group accepted cognitive behavioral intervention twice a week. Before and after the research, the patients were investigated with quality of life and distress scale. Results After the study of cognitive behavioral intervention, quality of life of experimental group scored (71.7±17.5) points which showed greater improvement than the control group scored (63.9±18.3) points (t=2.2,P<0.05), the distress score of experimental group was (2.6±0.6) points which was significant lower than the control group scored (3.9 ±0.7) points (t=11.8, P<0.05), and the proportions of distress problems contained anxiety [42.2% (27/64)], pain [29.7% (19/64)], depression [35.9% (23/64)] and sleep [23.4% (15/64)] in the experimental group were all significant lower than the control group [60.6% (40/66), 47.0% (31/66), 53.0% (35/66), 39.4% (26/66)]( X2=4.4, 4.1, 3.9, 4.5, P<0.05). Conclusions Short-term group cognitive behavioral intervention can alleviate the distress and pain, improve their negative emotions and sleep, eventually improve the quality of life of cancer patients.

In order to fully understand the anxiety level of the patients who will have ultrasound-guided puncture biopsy, and the survey results will guide the future clinical care to reduce the anxiety score of the patients, and to im-prove the satisfaction of them, which reflects the quality of care, we used Zung Self-rating Anxiety Scale (SAS) to investigate outpatients who will have ultrasound-guided puncture biopsy in a upper first-class hospital by convenience sampling way. The results showed that the SAS standard score of the patients was higher than the Chinese normal population's, and there is significant difference between the patients and the normal population's score (t = 47.12, P < 0.001). So for reducing the patients' anxiety level we should give health education and care intervention to the patients before the operation. This reflects the Patient-centered Culture and Excellent-quality Care in China.
Adolescent ; Adult ; Aged ; Anxiety ; etiology ; prevention & control ; Biopsy, Needle ; methods ; psychology ; Breast Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Male ; Middle Aged ; Patient Education as Topic ; Patient Satisfaction ; Surveys and Questionnaires ; Thyroid Neoplasms ; diagnostic imaging ; pathology ; Ultrasonography ; Young Adult

Objective To explore the effect of the pattern of nurse-patient double-check and signature in security management of intravenous administration and to understand the degree of satisfaction of patients with safe medication management.Methods The experience on security management of intravenous administration in inpatients from Oncology Department in the West China Hospital of Sichuan University were summarized from December 2015 to January 2017. Inpatients with intravenous administration between December 2015 and June 2016 acted as control group. Inpatients with intravenous administration between July 2016 and January 2017 acted as improved group along with the management method of the pattern of nurse-patient double-check and signature. The situation on security management of intravenous administration and the degree of satisfaction of patients with safe medication was compared between two groups.Results After implementing the pattern of nurse-patient double-check and signature along with intravenous administration, there was no medication administering errors (MAE). The degree of satisfaction of patients with safe medication raised from 94.20 % to 100.00% with a significant difference (P< 0.01).Conclusions The pattern of nurse-patient double-check and signature realizes the goal of patients' involvement in medical safety, ensures the infusion safety. It is worth to be used widely in clinical application.

Objective: To summarize the measures and experience of treatment in mass extremely severe burn patients. Methods: The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. All the 8 patients were accompanied with severe shock, inhalation injury, and blast injury. According to the requirements of former PLA General Logistics Department and Nanjing Military Command, a treatment team was set up including a special medical unit and a special care unit, with Chai Jiake from the First Affiliated Hospital of PLA General Hospital as the team leader, Zheng Qingyi from the 175th Hospital of PLA (the Affiliated Dongnan Hospital of Xiamen University) as the deputy leader, the 100th Hospital of PLA as the treatment base, and burn care, respiratory, nephrology, nursing specialists from the First Affiliated Hospital of PLA General Hospital, and the burn care experts and nursing staff from the 180th Hospital of PLA, 118th Hospital of PLA, 98th Hospital of PLA, and 175th Hospital of PLA, and nurses from the 85th Hospital of PLA, 455th Hospital of PLA, 101th Hospital of PLA, 113th Hospital of PLA as team members. Treatment strategies were adopted as unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns. With exception of one patient who received deep vein catheterization before admission, the other 7 patients were treated with deep vein catheterization 0.5 to 3.0 hours after admission to correct hypovolemic shock as soon as possible. Eight patients received tracheotomy, and 7 patients were treated with mechanical ventilation by ventilator in protective ventilation strategy with low tide volume and low volume pressure to assist breathing. Fiberoptic bronchoscopy was done one to three times for all the 8 patients to confirm airway injuries and healing status. Escharectomy and Meek dermatoplasty in the extremities of all the 8 patients were performed 3 to 6 days after injury for the first time. Escharectomy, microskin grafting, and covering of large pieces of allogeneic skin on the trunks of 4 patients were performed 11 to 16 days after injury for the second time. The broad-spectrum antibiotics were uniformly used at first time of anti-infective therapy, and then the antibiotics species were adjusted in time. The balance of internal environment was maintained and the visceral functions were protected. One special care unit was on responsibility of only one patient. Psychological intervention was performed on admission. The rehabilitative treatment was started at early stage and in company with the whole treatment. Results: Acute renal injury occurred in 5 patients within 36 hours after injury and their renal function was restored to normal 4 days after injury due to active adjustment of fluid resuscitation program. No pulmonary complications, such as severe pulmonary infection and ventilator-associated pneumonia, occurred in the survived patients. One of the 8 patients died, and the other 7 patients were cured successfully. The wounds were basically healed in 2 patients in 26 or 27 days by 2 or 3 times of operation, and in 5 patients by 4 or 5 times of operation. The basic wound healing time was 26-64 (48±15) days for all the 7 patients. Conclusions Treatment strategies of unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns are the bases to successful treatment. Correcting shock as soon as possible is the prerequisite and closing wound as soon as possible is the key to successful treatment. Comprehensive treatment measures, such as maintaining and regulating the function of viscera, improving the body immunity, and preventing and treating the complications, are the important components to successful treatment. It is emphasized that in the treatment of mass extremely severe burn patients, specialist burn treatment should always be in the dominant position, and other related disciplines may play a part in auxiliary function.

Objective: To explore the molecular biological mechanism of curcumol in regulating ferroptosis and autophagy. Methods: The Pharm Mapper database was used to screen out curcumol targets, various known related databases were used to establish a database of ferroptosis and autophagy related targets, and the String database was used to construct a protein-protein interaction network. The key targets were enriched and analyzed using DAVID database. Results: 152 curcumol targets, 259 ferroptosis targets, and 796 autophagy targets were obtained; curcumol mainly regulated the ferroptosis process through PTGS2, ALB, MAPK1, MAPK8, and MAPK14 targets, and curcumol mainly through HSP90 AA1, MAPK1, MAPK8, ALB, NOS3 targets regulated the autophagy process, and curcumol mainly regulated the ferroptosis and autophagy process through ALB, MAPK1, MAPK8 targets. Conclusion Curcumol can exert pharmacological effects by regulating ferroptosis and autophagy.