OBJECTIVETo explore risk factors of injection-related sharp injury and to provide safety injection guidance to healthcare takers.

METHODSA cross-sectional survey and 1:1 case-control study was used to study the epidemiological features and risk factors of sharp injuries among 3010 clinical nurses and nurse students from 13 hospitals in Guangzhou. Logistic multiple factor analysis was used.

RESULTSEighty-seven point five percent of nurses have suffered injuries at last once time. During the past month, 37.6% of the nurses have suffered injuries at least once time. The frequency of the injuries was 0.84 per person month. Through multiple logistic regression analysis, data showed that the risk factors leading to the sharp injuries in orders were: contacting the needle more frequently, subjectively thinking that the sharp injuries as unavoidable, the atmosphere in the nursing unit was not harmonious enough, recapping habit, carelessness at work, too many patients that not cooperating, breaking the ampule off without using carbasus, crowded and noisy working place, lack of acknowledge on prevention, lack of the awareness on how to avoiding the accident, having an initiative and creative personality etc.

CONCLUSIONThe results provided a foundation for the department of infection control in the hospital and sanitary administration department to constitute safety injection policies.

Case-Control Studies ; China ; epidemiology ; Cross Infection ; epidemiology ; etiology ; prevention & control ; Cross-Sectional Studies ; Female ; Hand Injuries ; epidemiology ; etiology ; Humans ; Injections ; Logistic Models ; Male ; Needles ; Needlestick Injuries ; epidemiology ; Nursing Staff, Hospital ; Retrospective Studies ; Risk Factors ; Surveys and Questionnaires

OBJECTIVE To investigate the clinical pathological characteristics of differentiated thyroid carcinoma (DTC) in children and adolescents. METHODS The clinical data of 30 children and adolescents with DTC were retrospectively reviewed. Meanwhile the clinical pathological characteristics of DTC were analyzed according to patients' age and gender. RESULTS Papillary thyroid carcinoma (PTC) was found in 27 cases and follicular thyroid carcinoma (FTC) in 3 cases. The average diameter of tumors was (2.56±1.1) cm. In the group of children, the incidence of lymph node metastasis was 92.3% (12/13), pulmonary metastasis was 46.2% (6/13), and those in the group of adolescents was 88.2% (15/17) and 35.3% (6/17) respectively. Children group tended to present with more vascular invasion, thyroid capsule invasion, and invasion out of thyroid, and a higher rate of cervical lymph node metastasis (P=0.025, 0.007, 0.025, 0.033). CONCLUSION Thyroid carcinoma in childhood and adolescent has a stronger invasive feature. It is easy to local invasion, lymph node and distance metastasis.

Objective To explore the methods, dosimetric features and short-term effects of partial breast irradiation carried out by three-dimensional external-beam irradiation (3DCPBI) assisted by active breathing control (ABC) . Methods Computed tomography (CT) simulation assisted by active breathing control (ABC) was carried out for each patient and intended to get CT images in condition of 75% deepest inspiration named moderate deep inspiration breath hold (mDIBH). The extent labeled by the silver slips located in the cavity was delineated as gross target volume (GTV) , GTV plus the margin of 15 mm was defined as planning target volume (PTV). 6 MV X-ray was selected as the radiation source and noncoplanar radiation with four three-dimensional conformal fields was used, the described dose was 34 Gy /10f/5d. The volume of GTV, PTV, the affected whole breast, and the percentage of PTV accounted for the affected whole breast , the percentages of PTV included by 100% , 95% and 90% isodose curve, the percentage of volume of the affected breast irradiated by 34. 0, 27. 2, 20. 4, 13. 6 and 6. 8 Gy , and Dmean,D5,V20 of the lungs and heart were calculated respectively. Acute radiation skin response was recorded and the cosmetic effect of the breast after radiotherapy were appraised, with the local tumor control and survival rate followed. Results The mean of volume ratio of PTV and affected whole breast was 14. 88% ; the mean of the volume covered by 90% isodose curve accounted for 92. 54% of the PTV; the volume irradiated by 34 Gy (100% of described dose) accounted for 17. 23% (mean) of the whole breast and 6. 8 Gy (20% of described dose) for 46. 11% , in other words, the volume covered by 20% of described dose was less than 50% of the whole breast. The Dmean, D5, V20 for the affected lateral lung were 1.97, 9. 25 Gy and 1. 58% , it was 0.20, 0. 87 Gy , and 0% for the unaffected lateral lung. The Dmean,D5, V20 for the heart was 0.65 Gy , 2. 82 Gy , and 0. 85%. Zero grade of acute radiation skin reaction was seen in 14 patients and gradel in 3 patients and there was not equal to or more than grade 2 of skin reaction for all the patients. Cosmetic effect were appeci-ated and satisfaction defined as excellent or good appearance of the irradiated breasts for all the patients. No recurrence of local tumor for all of the patients followed for one year. Therefore, the cosmetic result of 1 yr. follow - up was 100% and no recurence was found after 1 yr. follow - up. The 1-year tumor-free survival rate were all 100%. Conclusions For selected patients with early breast cancer after breast-conservative surgery, 3DCPBI assisted by ABC is feasible, however, the selection criteria for the patients, technique protocol and dose fractionation of 3DCPBI and its influence on late cosmetic effect, local tumor control and survival need to be continuously explored and observed in the future.

OBJECTIVESTo investigate the relationships among rotational alignment reference axes of distal femur and tibial mechanical axis, and determine the safest rotational alignment reference axis.

METHODSDigital photos were taken of 30 cadaveric lower extremities with knee in extension and flexion at 90 degrees , angles were measured among tibial mechanical axis and a line perpendicular to clinical epicondylar axis, a line perpendicular to surgical epicondylar axis, Whiteside's line and femoral mechanical axis. Statistical analysis of relationships among those axes were performed.

RESULTSThe angles among the tibial mechanical axis and a line perpendicular to the clinical epicondylar axis, a line perpendicular to the surgical epicondylar axis, Whiteside's line and femoral mechanical axis were 0.6 degrees varus, 3.9 degrees varus, 0.2 degrees valgus and 3.0 degrees varus respectively. The angle between the femoral mechanical axis and the tibial mechanical axis was significantly larger than the angles among the tibial mechanical axis and a line perpendicular to the clinical epicondylar axis, the Whiteside's line (P < 0.05). There was no significant difference compared with the angle between a line perpendicular to the surgical epicondylar axis and the tibial mechanical axis. Angles of the clinical epicondylar axis, the surgical epicondylar axis and the Whiteside's line between knee extension and flexion were 2.3 degrees valgus, 0.9 degrees varus and 3.1 degrees valgus respectively.

CONCLUSIONThe surgical epicondylar axis rather than the clinical epicondylar axis or the Whiteside's line is the safest femoral rotational alignment reference axis intraoperatively.

Arthroplasty, Replacement, Knee ; Biomechanical Phenomena ; Femur ; anatomy & histology ; surgery ; Humans ; Knee Prosthesis ; Rotation ; Tibia ; anatomy & histology ; surgery

OBJECTIVESTo introduce the technique of arthroscopic simultaneous reconstruction of posterior cruciate ligament (PCL) using double femoral tunnel, single-bundle transtibial tunnel PCL technique and anterior cruciate ligament (ACL) with achilles allograft, and to evaluate the clinical outcome.

METHODSFourteen patients with PCL and ACL injuries after a minimum follow-up 18 months were received. Arthroscopically assisted simultaneous ACL/PCL reconstruction with achilles allograft were performed using the single-incision endoscopic ACL technique and the double femoral tunnel, single-bundle transtibial tunnel PCL technique. The Lysholm and Tegner knee score scale were used for functional evaluation. All patients were evaluated with physical examination and KT-1000 arthrometer testing. The mean knee flexion was (123.6 +/- 2.5) degrees preoperatively. The Lysholm score was 52.8 +/- 2.2. The Tegner score was 5.9 +/- 0.5 before injury, 1.2 +/- 0.9 preoperatively.

RESULTSThe mean time from injury to the reconstructive procedure was 19.5 d. The mean knee flexion was (117.9 +/- 2.8) degrees postoperatively( t = 1.54, P = 0.14). As to the Lachman test for 14 patients, the results of 13 patients (92.9%) was negative. As to posterior drawer test, the results of 12 patients (85.7%) was negative. The Lysholm score was 92.9 +/- 3.3 at final evaluation (t = 17.009, P < 0.001). KT-1000 arthrometer testing at 25 degrees knee flexion showed that the side-to-side difference was below 2 mm in 9 cases, 3-5 mm in 4 cases, 6 mm in 1 case. At 75 degrees knee flexion the difference was below 2 mm in 10 cases, 3-5 mm in 3 cases, 6 mm in 1 case. The Tegner score was 5.4 +/- 0.8 at final evaluation. The difference between the preoperative score and the postoperative was statistically significant (F = 4.2, P < 0.01).

CONCLUSIONSCombined ACL and PCL injuries can be successfully treated with arthroscopic simultaneous reconstruction of PCL using double femoral tunnel technique and ACL with achilles allograft. The double femoral tunnel technique more closely approximates the anatomic insertion the native PCL. Most patients recover a functionally stable knee.

Achilles Tendon ; transplantation ; Adult ; Anterior Cruciate Ligament ; surgery ; Arthroscopy ; methods ; Female ; Femur ; surgery ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; surgery ; Transplantation, Homologous ; Treatment Outcome

The objective of this study was to investigate the expressions of TPO receptor (c-mpl) proteins on CD34 positive bone marrow cells (CD34+ BMCs), platelets and the expression of c-mpl mRNA in bone marrow cells of the patients with polycythemia vera (PV). The expressions of c-mpl proteins on CD34+ bone marrow hematopoietic cells of 13 PV patients and 15 normal controls were assessed by bicolor flow cytometry and the expressions of c-mpl proteins on platelets of 15 PV patients and 15 normal controls were assessed by monocolor flow cytometry, and the expressions of c-mpl mRNA in bone marrow hematopoietic cells (BMHCs) were assessed by RT-PCR. The results showed that no difference was found between the expression of c-mpl proteins on CD34+ BMHCs of PV patients (0.99% +/- 0.14%) and that of normal controls (0.92% +/- 0.12%) (p > 0.05). There was no difference too between the expression of c-mpl protein on platelets in PV patients (20.33% +/- 4.84%) and that in normal controls (23.50% +/- 3.64%) (p > 0.05). No difference between the expression of c-mpl mRNA in BMHCs of PV patients and that in normal controls was seen. In conclusion, the expressions of c-mpl proteins on CD34+ BMHCs, platelets and c-mpl mRNA in BMHCs of PV patients were not obviously abnormal.
Antigens, CD34 ; analysis ; Blood Platelets ; metabolism ; Bone Marrow Cells ; metabolism ; pathology ; Hematopoietic Stem Cells ; metabolism ; pathology ; Humans ; Polycythemia Vera ; genetics ; metabolism ; RNA, Messenger ; metabolism ; Receptors, Thrombopoietin ; metabolism

Objective To investigate the cognition level of nurse students on the influencing factors of nursing safety.Methods Totals of 371 nurse students prior to entering the bunch from three hospitals were involved in this study and relevant data were investigated with "The Questionnaire of Influencing Factors on Nursing Safety".Results The average scores of influencing factors ( list from highest to lowest priority) of four dimensions were that,"quality and expertise of nurse personnel" ( 4.584 ± 0.557 ),"administration of organization" (4.464 ±0.634),"work environment of nurse personnel" (4.319 ±0.693 ),"environment of clinic" (4.383 ± 0.685 ).The term score of "basic knowledge theory and operation skills" in the dimension of "quality and expertise of nurse personnel" "was highest ( 4.80 ± 0.443 ),and the" Drug put and marking" score in the dimension of "work environment of nurse personnel"was highest (4.61 ± 0.561 ),the term score of "medical equipment and ward products performance" (4.46 ± 0.64) was highest in the dimension of "environment of clinic",and "all kinds of rescue accident emergency plan" score (4.70 ±0.540) was highest in administration of organization dimension.Conclusions Nurse students can realize the importance of influencing factors of nursing safety. Strengthen consciousness of nursing students on nursing safety and regulations is important for cultivating nursing students' comprehensive quality and the capacity to prevent security risks and avoid the occurrence of mistakes and accidents in internship hospitals.

Objective To develop a eoexpression plasmid which expressing envelope protein and nucleoprotein of hepatitis B virus and know of its expressing efficiency. Methods The plasmid coexpressing envelope protein and nucleoprotein of hepatitis B virus under the CMV promoter respectively was constructed by gene recombination. Cellular expression was assessed by ELISA. Results Multiple cloning site was inserted into expression vector contain hepatitis B virus PreS2-S gene. And expression unit containing hepatitis B virus PreC-C was cloned into it. HBsAg and HBeAg was detected both in the culture supernatant and in the cells. Conclusion The coexpressing plasmid was constructed successfully and it can express effectively in vitro. This has provided a basis for further research of the therapeutic HBV DNA vaccine.

OBJECTIVETo investigate the clinicopathological features and prognosis of chromophobe renal cell carcinoma (ChRCC).

METHODSThe clinical data of 68 ChRCC cases treated in our department between January 2003 and September 2010 were collected and retrospectively analyzed. The prognostic factors were evaluated by Log-rank test. Kaplan-Meier survival curve was used to estimate the survival rate.

RESULTSFifty cases were treated with radical nephrectomy and 18 with partial nephrectomy. The mean tumor size was 5.7 cm (1.5 - 16.0 cm). The TNM stages were as follows: pT1aN0M0 in 25, pT1bN0M0 in 22, pT2aN0M0 in 9, pT2bN0M0 in 5, and pT3aN0M0 in 7. According to the Fuhrman grading system, 8 patients were classified as grade I, 42 cases were grade II, 14 cases were grade III, and 4 cases were grade IV. The 3-year and 5-year survival rates were 93.0% and 90.0%, respectively. The log-rank test showed that tumor size (> 7 cm vs. ≤ 7 cm) (P = 0.004), TNM stage (T1-2 vs. T3-4) (P = 0.008) and urinary collecting system invasion (P = 0.024) were associated with survival time. The multivariable Cox regression model revealed that tumor size (> 7 cm vs. ≤ 7 cm) was an independent predictor of aggressive ChRCC (P = 0.038).

CONCLUSIONSChRCC is a distinct type of renal cell carcinoma exhibiting a low degree of malignancy. Most tumors are larger, but predominantly with a favorable prognosis. Fuhrman nuclear grading is not suitable for ChRCC. Tumor size (> 7 cm vs. ≤ 7 cm) is an independent predictor of prognosis of ChRCC.

Adult ; Aged ; Carcinoma, Renal Cell ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Staging ; Nephrectomy ; methods ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Tumor Burden ; Young Adult

Fibrosis is the common end stage of most liver diseases. Unfortunately, there is no effective treatment available currently. This study was designed to evaluate the effect of Flk1+ mesenchymal stem cells (MSC) from murine bone marrow (Flk1 + MSC) on fibrosis formation induced by carbon tetrachloride (CCl4). In this study Flk1+ MSC were isolated from bone marrow of male BALB/c mice. A CCl4 induced hepatic fibrosis model was used. Flk1+ MSC were systemically infused immediately or one week after the female mice were challenged with CCl4. Fibrosis index and donor cell engraftment were assessed two or five weeks after CCl4 challenge. We found that Flk1+ MSC transplantation immediately, but not one week after exposure to CCl4, significantly reduced CCl4-induced liver damage and collagen deposition. In addition, levels of hepatic hydroxyproline and serum fibrosis markers (HA, P-III-P) in mice receiving immediate Flk1+ MSC transplantation after CCl4 challenge were significantly lower compared to those of control mice. More importantly, histological examination suggested that hepatic damage recovery was much better in these immediately Flk1+ MSC-treated mice. Immunofluorescence, PCR, and fluorescence in situ hybridization (FISH) analysis revealed that donor cells engrafted into host liver, had epithelium-like morphology and expressed albumin (ALB), although at low frequency. In conclusion Flk1+ MSC might initiate endogenous hepatic tissue regeneration, engraft into host liver in response to CCl4 injury, and ameliorate its fibrogenic effects.
Animals ; Carbon Tetrachloride ; Female ; Liver Cirrhosis, Experimental ; chemically induced ; therapy ; Male ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; cytology ; metabolism ; physiology ; Mice ; Mice, Inbred BALB C ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism