Objective To explore the effect of PDCA circulation on the effective utilization of the disposable articles in the operating room.Methods 9,362 aseptic articles for 446 operations in the departments of general surgery and hepatobiliary surgery during January to May 2012 were put in the pre-experiment group,in which PDCA circulation was not used.Another 11,973 articles for 501 operations in the same departments during June to November 2012 were set as the post-experiment group,in which PDCA circulation was used.The two groups were compared in terms of the effective utilization rate and the degree of doctor’s satisfaction with the nurses in the operation room.Result After the implementation of PDCA circulation,the effective utilization rate and the degree of doctor’s satisfaction were both significantly higher than before the implementation(both P<0.05).Conclusion PDCA circulation for the management of sterile disposable articles in the operation room may effectively improve the utilization rate of disposable articles, reduce wasting of articles and safe resources.

OBJECTIVE:To investigate toxic reaction of Compound zedoary turmeric oil cream in experimental rats with long-term consecutive transdermal administration,and to provide reference for safe use of it in the clinic. METHODS:60 SD rats were randomly divided into blank control (cream matrix) group,Compound zedoary turmeric oil cream intact skin and damaged skin low-dose and high-dose(5%,10%)groups,with 12 rats in each group,half male and half female. All of them were given relevant medicine twice a day. 92 d consecutive medication later,general situation of rats were observed,and body weight,blood routine(WBC,RBC,HGB,LYMPH,etc.)and blood biochemical indicators(AST,ALT,PA,etc.)were all detected;systemati-cal observation of organs,organ coefficient calculation and histopathology examination were carried out. RESULTS:There was no statistical significance in those indicators between Compound zedoary turmeric oil cream groups and blank control group (P>0.05),except hemoglobin decreased in intact skin low-dose group,while hemoglobin decreased,LYMPH and PA increased in dam-aged skin high-dose group(P<0.05). Pathology results showed that Compound zedoary turmeric oil cream had no significant toxici-ty for the main organs. CONCLUSIONS:Compound zedoary turmeric oil cream has no long-term toxicity to experimental rats.

This article was aimed to study the therapeutic effects and anti-inflammatory effects of Chinese and west-ern medicine ointment on fungal infection animals. Guinea pig models which were infected with Trichophyton rubrum or Microsporum lanosum were applied to observe the effects of antifungal infections on She-Zhi Qin-Xian (SZQX) ointment by transdermal administration. The ointment is the combination of miconazole nitrate, snake oil and Sophora flavescens which is traditional Chinese medicine (TCM). Simultaneously, the models of croton oil-induced mouse ear swelling and carrageenan-induced rat paw swelling were established to observe the curative effect of SZQX ointment. The results showed that the SZQX ointment had a protective role on both guinea pig models. The microscopic scale of localized lesions in infected guinea pigs was significantly decreased (P< 0.01). The effect of SZQX ointment was better than the single using of Chinese or western medicine. The SZQX ointment was also able to significantly reduce the croton oil-induced mouse ear swelling and carrageenan-induced rat paw swelling (P< 0.05, or P< 0.01) with distinct anti-inflammatory effect. And the effect of SZQX ointment was superior to the single using of either Chinese or western medicine. It was concluded that the SZQX ointment had significant antifungal infection and anti-inflam-matory effect.

The pathogenesis of diabetic retinopathy (DR) is complex.Antisense non-coding RNA (ANRIL) in the INK4 locus in long-chain non-coding RNA (lncRNA) is closely related to cell proliferation,differentiation,and individual development.It plays an important role in the dysplasia of retinal vascular endothelial cells and is a new field in the study of the pathogenesis of DR.According to the researches at present,ANRIL may plays its role in the occurrence and development of DR through the signal pathway of nuclear factor-κB and ROS/polyadenylation diphosphate ribose polymerase,and interact with p300,miR-200b,and EZH2 to regulating the expression and function of VEGF.Specific blocking ANRIL and its related pathwaysmay become a new target in the treatment of DR.

Objective To explore the clinical features and radiological findings of patients with Sturge-Weber syndrome (SWS).Methods A retrospective study was performed on the course of illness,clinical data and neuroimages of 8 patients with SWS,admitted to our hospital from June 2012 to November 2015.Results The main symptoms included facial hemangioma in 7 patients,epilepsy in 5 patients,headache in 4 patients,limb hemiplegia in 3 patients,glaucoma in 3 patients,and thyroid dysfunction in one patient.Neurological imaging showed subcortical calcification,brain atrophy,gyriform enhancement and increased pial vascular tortuosity.Fundus examination revealed optic atrophy and vascular malformations of choroid.All symptoms in the patients were alleviated after treatment.Conclusions SWS should be highly suspected in young patients who present with typical glaucoma,epilepsy or hemiplegia with/without facial hemangioma.CT angiography or MR imaging (especially susceptibility-weighted imaging) is required to confirm the diagnosis.If medications fail to control seizures,surgery could be considered in some patients.

Based on the background of "Internet +", this paper introduces the development background of the "Shared Nurses" nursing service model in China and the development status of nursing services at home and abroad, and analyzes the problems in its implementation. This paper also proposes corresponding development strategies based on actual conditions, so as to provide a reference for the further development of this model.

4K laparoscopy brings opportunities and challenges to the development of rectal surgery. 4K laparoscopy can truly provide the structure of abdominal and pelvic fascia, so that surgeons can see more subtle anatomical structure. The clear and real picture under 4K laparoscopic system can reduce visual fatigue of surgeons, which make the operation easier and safer. Radical resection of right colon cancer includes complete mesocolic excision and D 3 lymphadenectomy. Through 4K laparoscopic system, surgeons can easily observe the fascia structure of right mesocolon and its mesenteric bed, distinguish the vascular anatomical relationship at the mesenteric root, which make D 3 lymphadenectomy safer with dissection of lymph nodes completely. The authors comprehensively analyze the related research progress at home and abroad, and systematically elaborate the region of dissection and significance of 4K laparoscopic right hemicolectomy for right colon cancer.

Digestive tract reconstruction with side-to-side esophagojejunostomy is one of the most commonly used digestive tract reconstruction methods after laparoscopic total gastrectomy. It does not need an auxiliary incision. The linear stapler is used to directly enter the abdominal cavity through the Trocar to perform side-to-side anastomosis of esophagojejunostomy. The common hole can be closed by hand suture or linear stapler. 4K laparoscopy can present a clearer and more realistic view to the operators, so as to realize side-to-side esophagojejunostomy more accurately, to reduce the postoperative anastomo-tic related complications and improve the safety of the operation. This article will elaborate the technical key points and difficulties of esophagojejunostomy in 4K laparoscopic total gastrectomy, as well as the prevention and treatment of anastomotic related complications.

Objective:To evaluate the long-term safety, tolerability and efficacy of Lacosamide add-on therapy in Chinese children with partial-onset seizures.Methods:SP848 was a global multicenter single-arm study involving 60 Chinese children with partial-onset seizures with the age of 4-17 years who were managed by Lacosamide add-on therapy at seven hospitals across China from April 2018 to May 2019.After treatment with at least two kinds of anti-seizure medications simultaneously or sequentially, partial seizures were still poorly controlled and Lacosamide oral solution (syrup) or tablets were added.The minimum initial oral dose was 2 mg/(kg·d), and the maximum allowable dose was 12 mg/(kg·d)or 600 mg/d during the study period.The dose was adjusted according to the tolerance and seizure control level of partial-onset seizures children.Seizure frequency and the median percentage change in partial-onset seizures per 28 days from baseline to the final visit were recorded, including 50% responder rate and 75% responder rate.Results:A total of 60 Chinese children with the mean age of 9.18 (4.00-15.40) years were included in this interim analysis, involving 39 males and 21 females.The mean course of epilepsy was 5.04 (0.50-15.20) years.A total of 43 patients (71.7%) still have been treated.One patient (1.7%) has completed the 6-12 months of follow-up, and 14 patients (23.3%) have completed the follow-up for less than 6 months.The median change in the frequency of partial seizures every 28 days from baseline to the last visit was -2.91, with its median percentage as -25.46%, and the proportions of ≥50%, while ≥75% responder rate were 40.0% and 28.3%, respectively.A total of 52 patients (86.7%) had 265 treatment emergent adverse events (TEAE), 11 patients (18.3%) had 19 serious TEAE, 37 patients (61.7%) had 127 drug-related TEAE, and 11 patients (18.3%) had 16 TEAE leading to the discontinuation of the trial.The most common TEAE were upper respiratory tract infections (20 cases, 33.3%), followed by drowsiness (16 cases, 26.7%), dizziness (15 cases, 25.0%) and vomiting (13 cases, 21.7%). There were no abnormal changes in the electrocardiographic findings during the treatment.Conclusions:For Chinese patients with partial seizures who are older than the age of 4 years and poorly controlled by other drugs, Lacosamide is effective and well tolerated as an add-on therapy drug.The safety characteristics are consistent with those reported in children and adults.No new safety concerns are identified.

Objective:To investigate the effect of automated nested multiplex PCR system in the detection of children with severe community-acquired pneumonia(CAP), and identify the pathogenic infection of the children with severe CAP in Foshan.Methods:Children with severe CAP, who were admitted to the PICU at Foshan First People′s Hospital from January 2016 to December 2018, were enrolled in the analysis.Nasopharyngeal secretions were collected.And automated nested multiplex PCR was used to detect adenovirus, coronavirus (HKUl type, NL63 type, 229E type, 0C43 type), human metapneumovirus, influenza A virus (H1 subtype, H1-2009 subtype, H3 subtype), influenza B virus, parainfluenza virus (type 1, type 2, type 3, type 4), respiratory syncytial virus, Bacillus pertussis, Chlamydia pneumoniae and Mycoplasma pneumonia.Results:Among the 290 specimens detected by the automated nested multiplex PCR, 246(84.83%) were positive.There were 166 positive samples for a single pathogen, 60 positive samples for two pathogens, 17 positive samples for three pathogens, and three positive samples for four pathogens.Among the virus-positive cases, respiratory syncytial virus was the most common pathogen in children younger than 6 months(62.39%, 73/117). The most common pathogen was human rhinovirus/enterovirus(43.48%, 20/46) from seven months to one year old.Adenovirus(37.50%, 18/48) was the most common pathogen among children aged one to three years old.Rhinovirus/enterovirus(35.00%, 7/20) was the most common pathogen among children aged three to six years old.The most common pathogen in children over six years old was influenza virus(46.67%, 7/15). The adenovirus detection rate was highest in May, the syncytial virus detection rate was highest in August, and the influenza virus detection rate was highest in July.Mycoplasma pneumoniae and pertussis were distributed throughout the year.Conclusion:The automated nested multiplex PCR system can detect multiple pathogens efficiently, quickly and accurately; the common pathogens of severe CAP are diverse in different age groups; the epidemic season of common pathogens is unique in different regions due to different climates.