Objective To observe the Influence of improved ICU checklist on instrument management. Methods Reformed and improved the instrument delivery project in ICU checklist. The transfer situation from November 2014 to April 2015 as the control group.The situation from May to October in 2015 as the observation group.Compared the two groups of items of the transfer situation,the condition of nurses′ mastery of instrument parameters,the number of adverse events associated with the instrument and the satisfaction degree of the doctor on nursing work. Results Experimental instrument handover items in succession rate, incidence of adverse events, the doctor to nurse job satisfaction were 25.3% (278/1098), 6 cases, 93% (27/29), the control group were 59.6% (655/1098), 20 cases, 81% (17/21), the difference was statistically significant (χ2 = 264.868, 7.629, 70.046, P < 0.05 or 0.01). Conclusions Improved ICU checklist on instrument management can effectively promote nurses′mastery of instrument parameters, reduce the occurrence of nursing adverse events, ensure patient safety, improve the doctors′ satisfaction on nursing job, and provide an important basis for nursing safety management department.

Objective To explore the method and effect of checklist tool implemented in the safety management of clinical blood transfusion in intensive care unit. Methods A checklist was specially designed according to the technical standard and check system of clinical blood transfusion. 379 patients prescribed a blood transfusion enrolled in ICU from January to May 2013 were conducted as the control group before the checklist was designed. After the application of checklist during the blood transfusion process, 846 patients prescribed a blood transfusion enrolled in ICU from June to December 2013 were conducted as the experimental group. The incidence of blood transfusion safety related adverse events between the two groups was compared. Results The incidence of adverse events was 1.32% (5 of 379 patients) in the control group, and there was no sign of adverse events occurred in the experimental group. The difference had statistical significance (χ2=11.21, P<0.05). Conclusion The application of checklist reduced the incidence of blood transfusion safety related adverse events,and effectively improved the quality of nursing safety and patient satisfaction.

BACKGROUND:Bone marrow is the main source of mesenchymal stem cells(MSCs)at present,but its application has been limited,because of some reasons such as inconvenience of isolation,and the quantity of cells decreases with human increased age.Umbilical cord as a new source of MSCs has been widespread concerned recently.OBJECTIVE:To explore the approach of isolating and culturing MSCs from Wharton's jelly of human umbilical cord,and the methods of identifying the surface antigens and the differentiation potential.METHODS:MSCs were isolated and amplified via tissue-cultivation,and cultured by FasGrow medium.Morphology of MSCs from Wharton's jelly of human umbilical cord was observed under the optical microscope.Its immunophenotypes were detected using immunohistochemistry.The differentiation of MSCs into the osteoblasts was determined utilizing Gomori calcium-cobalt alkaline phosphatase staining,von Kossa calcium node staining,and tetracyclinefluorescence labeling.The differentiation of MSCs into the adipocytes was detected using oil red O staining.RESULTS AND CONCLUSION:MSCs were easily obtained from Wharton's jelly of human umbilical cord via the proposed approach.The primary cells grew up to 70%-80% confluence after 12-16 days of culture,and meanwhile the undifferentiated state was maintained and proliferation was stabilized after passage.The cell cycle of double increase was about 2 days,and proliferation in vitro reached twenty generation above.Surface antigen analysis showed that CD44,CD105,CD133,MHC-I were positively expressed,while CD34,CD45 were negatively expressed.Experiments of differentiation in vitro indicated that the obtained cells were capable of differentiating into fat,osteoblast and nerve-like cells.

Objective To investigate the pharmacodynamic action of Yunkang Capsule(YKC).Methods The animals were divided into YKC groups(at high-,moderate-and low-dosage respectively),diphenidol control group,model control group and blank control group.The action of YKC on vertigo and thrombosis,hemorrheologic indexes,piamatral microcirculation and free radicals of the animal models were observed.Results YKC could significantly prolong the latency of vertigo,reduce wet weight of thrombus,decrease blood viscosity,plasma viscosity and hematocrit,promote the dilation of piamatral micro-vessels,increase the amount of interweave microdot,increase plasma SOD activity and decline plasma MDA content of animal models.Conclusion YKC has actions of counteracting vertigo and thrombosis,improving hemorrheology and microcirculation,and clearing away free radicals.

Objective To report the clinical results of one stage reconstruction of high-energyinjured limbs. Methods From January 2001 to July 2006,one stage reconstruction was done on 55patients suffered from massive limb trauma,severe open fractures or spoiled limbs caused by high energy.There included 16 patients with Gustilo Type-Ⅲ C fractures,with mangled extremity severity score (MESS)of(6.25 ±2.53)points.All patients were treated with transplantation of free flaps or pedicle skin flaps,fracture fixation,nerve reconstruction or functional reconstruction. Results All limbs were saved and all flaps were transplanted successfully.without protracted course to obtain soft tissue coverage.The hospitalization was mean 24 days(12-63 days)and follow-up ranged from 12 months to 50 months (averaged 23 months).Complications including wound infection,bone nonunion,necrosis and morbidity were significanfly less likely to appear than conventional ways and the ultimate functional results of the saved limbs were at least better than that of artificial ones. Conclusions In comparison with traditional methods,one stage reconstruction of severe high energy-injured limbs has advantages of easier justification of tissue structure,better match of donor and recipient blood vessels,easier operation design,shorter hospitalization and better functional recovery.Definitive wound closure with vascularised tissue transfer can facilitate local blood supply.decrease bone infection and hence promote bone healing.

Objective To investigate the long-term efficacy of PEG-IFN alpha-2a (PEG-IFNα-2a)plus ribavirin (RBV)in treatment of chronic hepatitis C (CHC)patients with IL28B single nucleotide polymorphisms (SNPs)rs12979860 C/C type in different HCV genotypes.Methods A prospective study was conducted on 38 CHC patients from our hospital's Infection Department from March 2011 to September 2015.The patients were treated with PEG-IFNα-2a/RBV for 48 weeks.A 42-month follow-up of patients was performed after withdrawal of treatment.The main paramenters to value the efficacy were liver function,blood lipids,and sustained virological response (SVR).Results In the CHC patients with IL28B SNP rs12979860 C/C type,the rate of SVR in patients with antiviral therapy had no significant difference between groups 1b and 2a (73.33% and 95.65%,respectively, P＞0.05).After anti-HCV therapy,liver function indices such as ALT,AST,TBIL,TC,TG and HDL all significantly improved in the two groups (all P＜0.05).However,there was no difference in biochemical indices (ALT,GGT,bilirubin,blood lipids)between the two groups (all P＞0.05).Conclusion In CHC patients with IL28B SNP rs12979860 C/C type,the long-term efficacy of PEG-IFNα-2a/RBV is good.IFN-based antiviral therapy has a higher SVR rate,and liver function and lipid metabolism can be significantly improved.

OBJECTIVEThis study was to construct a geometric skull model with 3-dimension scanning and rapid-prototyping (RP) technology and also to evaluate the significance and further application of surgery simulation in the treatment of complex craniomaxillofacial malformation.

METHODSTwelve patients with complex craniomaxillofacial malformation were involved. The data obtained with CT scanning were transferred to a personal computer for surface rendering 3-dimension reconstruction. A geometric model was manufactured by selective laser sintering using rapid-prototyping device. Surgery simulation was performed both on the model and in the computer. Accordingly, a custom implant and an implant template, when needed, were constructed with the computer-aided design (CAD) and prefabricated with computer-aided manufacture (CAM) process.

RESULTSSurgery simulation made the operation shorter, the complications lower and the outcome better.

CONCLUSIONSSkull model provides great convenience in the treatment of cranio-maxillofacial malformation.

Adult ; Computer-Aided Design ; Craniofacial Abnormalities ; diagnostic imaging ; therapy ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Models, Anatomic ; Skull ; anatomy & histology ; Tomography, X-Ray Computed

OBJECTIVETo observe the clinical efficacy and safety of Tiaozhi Yanggan Decoction (TZYGD) in treating non-alcoholic fatty liver.

METHODSOne hundred and thirty-eight patients were enrolled and randomized into two groups according to the random number table in a ratio of 3:1, with 8 cases eventually dropping out. The symptoms, signs, liver function markers, blood lipids, iconographic indices and clinical comprehensive efficacy after a 12-week treatment course were assessed in 101 patients treated with TZYGD in the treated group and 29 patients treated with Thiola in the control group.

RESULTSThe total effective rate in the treated group and the control group was 81.19% and 68.97%, respectively, showing a significant difference between the two groups with the former being significantly higher than the latter (P<0.05). Moreover, the improvements in the symptoms, signs, liver function, blood lipids and iconographic indices in the treated group were favorable with no serious adverse reactions.

CONCLUSIONTZYGD is effective and highly safe in treating non-alcoholic fatty liver.

Adult ; Body Mass Index ; Body Weight ; drug effects ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Fatty Liver ; blood ; drug therapy ; physiopathology ; Female ; Humans ; Lipids ; blood ; Liver ; physiopathology ; Male ; Medicine, Chinese Traditional ; adverse effects ; methods ; Middle Aged ; Phytotherapy ; adverse effects ; Treatment Outcome

Objective To investigate the effects of F protein of hepatitis C virus subtype lb on the apoptosis of human hepatocellular carcinom HepG2 cells. Methods HepG2 cells were transfected with recombinant plasmid pcDNA3.0-F-EGFP and pcDNA3.0-F-EGFP-HepG2 strain was exposed to Act-D and tumor necrosis factor a (TNFα) treatment in order to induce cell apoptosis with positive control pcDNA3.0-C-EGFP-HepG2, negative control pcDNA3.0-C-EGFP-HepG2 and blank control HepG2.Annexin V-FITC/PI of flow cytometry was performed to determine the number of apoptotic cells. DNA Ladder was used to observe the isolation of apoptotic DNA fragments in the apoptotie cells. Results pcDNA3.0-F-EGFP- HepG2 cell strain showed a much delayed apoptosis as well as obviously lowering the apoptotic rate when compared with the pcDNA3.0-HepG2 strain and HepG2 strain (P<0.001).Conclusion The introduction and expression of extraneous gene (the F gene of hepatitis C virus subtype 1b) could significantly inhibit the apoptosis of HepG2 cells.

Objective To study the mlationship between dietary soy isoflavones and blood lipids among residents of 40-65 years old,in Guangzhou.Methods Dietary soy isoflavones and other nutrients intakes were assessed with quantitative food frequency questionnaire(FFQ).Total cholesterol(TC),triglycerides(TG),HDL cholesterol(HDL-C)and LDL cholesterol(LDL-C)in plasma were measured with colorimetry.Results Ranges of dietary soy isoflavones intake among 134 males and 261 females were fxom 0 mg/day to 61.96 mg/day and 0 mg/day to 82.52 mg/day,with means of 11.95 mg/day,14.90 mg/day,respectively.After adjusted for total energy intake and fat percent energy,difiefences of TC,LDL-C in total population and TC in women were statistically significant between groups(P value was 0.002,0.008,0.004,respectively) and dose-effect relationships(P value was <0.001.0.012.0.001,respectively)were observed between dietary soy isoflavones intake and the upper mentioned three indices.Compared with the low-intake group,tbese three indices lowered 7.06%,10.13%and 7.48%,respectively in high-intake group.Critical significance of LDL-C was observed both in women and men between groups.Further controlled for age,BMI and WHR,no obvious change of the results was observed.Conclusion Moderate intakes of soy isoflavone as part of a regular diet seemed to be associated with favorable blood lipid levels.