The pre-examination process is the first key step in the total testing process of clinical laboratories.Specimen acceptability is an important indicator to measure the quality of pre-examination.In order to identify the risks and the root causes in the process , establishment and monitoring of quality indicators about specimen will effectively control the risks , enhance the acceptability of specimens , promote the improvement of pre-examination quality and finally get the aim of assuring patients′safety.

OBJECTIVE:To evaluate the pain-relieving and sedative efficacy and safety of sufentanil in patient-controlled intravenous analgesia after spinal column surgery.METHODS:60 patients undergoing selective spinal column surgery were randomized to either fentanyl group or sufentanil group.General anesthesia was performed for all the 60 cases,with tracheal catheter withdrawn and patient-controlled intravenous analgesia(PCIA) performed after completion of surgery when patients had regained consciousness.The analgesic efficacy within 24 hours was evaluated using visual analogue score(VAS),VRS score,Ramsay score and the adverse effects were recorded.RESULTS:In sufentanil group,effective analgesic efficacy was obtained,and the VAS score was significantly lower but the VRS score was significantly higher than in fentanyl group(P0.05).CONCLUSION:Sufentanil is proved to be safe and effective with reliable analgesic and sedative efficacy but fewer side effects for PCIA patients.

Acute kidney injury(AKI)has become the public health problem that harms the human's health, is a common critically illness,characterized by complicated etiology,high prevalence,high risk of combine other organs'injury and high mortality,these become the huge challenge in clinic.Thus,it is valuable in clinic how to improve cog-nition about AKI,to early detection,to early treatment so that postpone pathogenetic condition,increae survival rate and improve prognosis.In recent years,the researchers have processed vast of reseaches about etiology,new biomark-er,risk fator,prognosis,etc.However,these parts are still controversial.This paper summarizes the research progress of AKI.

Objective To discuss the nursing for the different postoperative residual urine of patient with pelvic floor dysfunction.Method To evaluate the nursing for the postoperative residual urine of patient with pelvic floor dysfunction and the time of urinary catheters inserted,We completed a retrospective review of 138 adult patients.Results ①Toally 138 participants were categorized into 3 groups:74 (53.6％) patients carried a residual volume ＜ 100ml,53 (38.4％) patient did 100～300ml,11 (8.0％)did ＞300ml.②About11 patients who were able to void but carried a residual volume ＞300ml required indwelling catheterization.In these cases,100％ carried a residual volume ＜ 100ml after indwelling urinary catheter extraction (IUCE) after 4～5 days.③About 53 patients who were able to void but carried a residual volume between 100ml to 300ml received urine nursing,phychological nursing and bladder function exercise.Two days after IUCE 41 (77.4％) patients' residual volume was ＜100ml;three days after IUCE 11 (20.7％) patients' residul volume was ＜100ml;five days 1 patiens' residul volum was ＜100ml.Conclusion When a postvoid residual＞300ml,the patient should be performed catheterization,When a postvoid residual between 100ml to 300ml,the nurse should give the patient mental easing and teach them to perform pelvic floor muscle exercise.This can reduce the suffering of patients.

Objective To know the effects of using hierarchical management for psychiatric nursing in psychiatric ward,and then to offer some rationales and theoretical support for hospital management.Methods The fine hierarchical management was implemented from Janurary 2012 in Xi'an Mental Health Center and the metal hygiene clinics of Xi'an Jiaotong University.Before and after the hierarchical management carried out,the nursing care quality was assessed among the family members of hospitalized patients by using satisfaction survey questionnaires,flight rate of patients was evaluated,and at the same time,nursing care quality and the nurse comprehensive ability was inspected.And then,the EPIDATE 3.0 and SPSS16.0 software was used to analyze and compare the satisfaction scores.The nurse comprehensive ability,and nursing care quality scores before and after implementation.Results The nurse comprehensive ability were improved.The satisfaction scores of family members of hospitalized patients was higher than that before implementation after the fine management implementation,which had statistical difference,P＜ 0.05.The satisfaction rate of patients' family member was 96.77％(2 543/2 628) after the fine management implementation,which was significant higher than that of before implementation,91.19％(2 382/2 612),x2=107.66,P＜0.05.Flight rate of patients was reduced after the hierarchical management,which was significantly lower than that of in before,P＜0.05.Nursing care quality scores were higher than those of in before,which has a statistical difference respectively,P＜0.05.Conclusions The hierarchical management could improve the satisfaction of family numbers,reduce the flight rate of patients,enhance nursing care quality and improve the nurse comprehensive ability.It would reduce the incidence of medical malpractice.The fine hierarchical management is worth to be applied and generalized in nursing care of psychiatric nursing in psychiatric ward.

The pre-analytical process is the first key step in the total testing process of clinical laboratories,which will directly influence the accuracy and timeliness of testing results.Efficient preanalytical quality assurance system consists of scientific personnel structure,regular training and monitoring,bright and comfortable phlebotomy environment,advanced comprehensive phlebotomy facilities,strict biosafety practice in each procedure and harmonious relationship between clinicians/patients and laboratory.Besides,the application and monitoring of sound quality indicators in pre-analytical process will promote the improvement of quality and finally get the aim of assuring patients' safety.

[Objective] To investigate the effects of Eucommia on renal interstitial fibrosis and its mechanism.[Methods]Using renal interstitial fibrosis in rats with Unilateral Ureteral Obstruction(UUO).Adult female SD rats(n=32) were randomly divided into 4 groups: Sham operation group (Sham); UUO group,Irbesartan group; Eucommia group.Undergo light microscopy by Masson and HE staining to observe the renal interstitial fibrosis index.To detect the expression of MMP-2 by immunohistochemistry 2w after surgery.[Results] 1.The levels of BUN and Scr in UUO group were significantly higher than in Sham group.Compared with UUO group,the levels of BUN and Scr in irbesartan and eucommia groups were significantly lower.There was no significant difference between irbesartan group and eucommia group.2.The renal tissue was stained with HE.There was no change in Sham group.But in UUO group,there was tubular epithelial cells denaturalization,renal tubular expand or atrophy,interstitial macrophage and monocyt infiltration,interstitial expand,and there was no glomeruli change.While the change in irbesartan and eucommia group was slighter than that in UUO group.There was no significant difference between irbesartan group and eucommia group.3.The renal tissue Masson staining showed that there was interstitial expands fibrous tissues proliferation and there was no glomeruli change in UUO group.Compared with UUO group,the level of pathological change in irbesartan and eucommia groups was significantly lower.There was no significant difference between irbesartan group and eucommia group.4.The expression and distribution of MMP-2 were strong in Sham group,while in other groups lower in renal interstitial.Compared with UUO group,the level in irbesartan and eucommia groups was significantly higher.There was no significant difference between irbesartan and eucommia groups.[Conclusion] Eucommia inhibits the renal interstitial fibrosis lesion up-regulating the MMP-2 expression and blocking renal fibrosis.

Robot-assisted surgery is becoming a widely popular technology and now entering total knee replacement. The development of total knee replacement is introduced in this paper with the emphasis on femur positioning technologies. The experiments and error analysis of robot-assisted surgical system for total knee replacement demonstrate that femur positioning technologies have a high precision and thus deserve to be popularized theoretically and practically.

Objective To observe the change of endothelium-dependent vasodilatation function and to explore its mechanism in insulin-resistant (IR) rats induced by high fat feed. Methods (1) IR rat model was established by high fat feed for 4 weeks and IR was evaluated by glucose infusion rate (GIR) of euglycemic hyperinsulinemic clamp technique. (2) Acetylcholine (Ach)-dependent vasodilation response and nitric oxide synthase (NOS)-nitric oxide (NO)-cGMP function status were observed in isolated aorta of rats. Results (1) GIR was obviously lower in high fat feed group than that in routine feed group (P

Objective To determine the added clinical applications of MR virtual endoscopy (MRVE) plus MRCP in cholangiopancreatography. Methods In 14 month, 44 patients with obstructive jaundice and symptomatic bile trace were assessed by MRVE in biliary tract.The 2D data of heavily T 2 weighted images with FSE(non breath hold, respiratory trigger) and SSFSE(breath hold, multi slice single shot fast spin echo) sequence were transferred to the computer workstation. Navigator software (GEMS) was used to display intraluminal views of the pancreaticobiliary tract with a surface rendering technique. Results Patients suffered from neoplasm ( n =18), bile stone (17), postoperative complications of cholecystectomy( n =3), and other disease of biliary tract( n =6). MRVE could clearly demonstrate the anatomical structures in biliary tract, extended pancreas tract,biliary meatus narrowing and obstruction, bile duct stones, duct branches, and the inner wall of pathological obstruction.The main limitation of virtual endoscopy was inability to evaluate mucosa and lack of histological diagnosis. Sensitivity for detection of bile duct dilatation and site of obstruction was: 2D FSE 91 7%, and SSFSE 97 9%. Conclusion MRVE provided noninvasively endoscope like display of biliary tract.Its display ability was a supplement to image biliary trace. MRVE effect of multi slice SSFSE sequence was better than that of fast spin echo.