Objective To analyze characters and causes of medical safety (adverse) events and to propose corresponding countermeasures.Methods 322 medical safety events in some tertiary hospitals were analyzed by using the root causes analysis method.Results Identifying errors,medical defects,medicine mistakes were the top 3 events possessed 16.77％ (54/322),16.15％ (52/322),13.98％ (45/322);The top 3 departments were Neurology,General surgery,Oncology which possessed 9.63％ (31/322),7.45％ (24/322),7.14％ (23/322).Medical staff with a title of middle and highly were involved in possessed 33.23％ (107/322),25.78％ (83/322),and nursing staff was the top one possessed 56.83％ (183/322).Night working shift was the maximum occurrence time possessed 39.75％ (128/322).The top 3 medical acts which more easier to trigger medical adverse events were incomprehensive nursing care,irregular operation of diagnosis and treatment,clinical supervision defect which possessed 17.39％ (56/322),15.84％ (51/322),15.22％ (49/322).The slight consequence case was the top one possessed 47.20％ (152/322).Resolving the dispute by consultation between hospital and patient was the main way possessed 82.26％ (51/62).Conclusions More attentions should be paied to supervision of some certain department management and key sections,and improve the professional technical level,do preventive construction systems about medical safety (adverse) as well as emergency event handling construction mechanism by consummate supporting system and effective staff arrangement.

Objective To investigate the effect of the levels of serum high sensitive C reactive protein and its clinical effect by bifidobacteria combined zinc in the treatment children with diarrhea.Methods 100 children with diarrhea from June 2013 to June 2016 in our hospital were selected and randomly divided into the control group and the experiment group,50 cases in the control group were get general routine treatment,such as dehydration and zinc supplement,50 cases in the experiment group were treated on the base of the control group with bifidobacteria.The clinical curative effect,the disappearance time of clinical symptoms of diarrhea and the level of serum high sensitive C reactive protein(CRP),interleukin-10(IL-10)and interleukin-6(IL-6)were observed and compared between two groups.Results After treatment,the total effective rate of the treatment group was higher than that of the control group,the clinical symptoms disappeared earlier than the control group,the difference was statistically significant(P<0.05).The serum CRP,IL-10 and IL-6 levels were lower than before treatment and the experiment group was more lower,the difference was statistically significant(P<0.05).Conclusion The clinical efficacy and recovery time of the combined application ofbifidobacteria and zinc in children with diarrhea is related to the decrease of serum CRP,IL-10 and IL-6 levels.

This paper explored the educational reform of dispensing Chinese drugherbs. The education reform included implementing the project of teaching methods, implementing modern experimental methods, cultivating comprehensive quality of students, training students' creative thinking, and stimulating the initiative of students. All these strategies could improve the quality of teaching and make students' comprehensive abilities meet the demand.

Objective To explore the appropriate frequency of ventilator tube replacement by researching the influence of different ventilator circuit change frequency on ventilator-associated pneumonia (VAP).Methods A prospective randomized sampling study was conducted.The patients undergoing invasive mechanical ventilation over or equal to 3 days admitted to emergency intensive care unit (EICU) of the First Affiliated Hospital of Kunming Medical University from December 2012 to December 2015 were enrolled.The patients were divided into 3,7 and 10 days group according to the frequency of ventilator tube replacement.Bacteriology of ventilator tube and the incidence of VAP were compared among the groups.Results Ninety-eight patients were enrolled,mainly with the artificial airway of endotracheal intubation or tracheotomy,with 56 male and 42 female,aging 8 to 86 years with mean of (51.97 ± 17.56) years.There were no statistical differences in gender,age,Glasgow coma scale (GCS) score,cough function and application of glucocorticoid,enteral nutrition,atomization and sedative therapy among three groups,indicating that the risk factors among three groups were consistent.The bacteria detection rates of extension tube,breathe out tube,breathe in tube,and hydrops collection cup were 36.7％,36.7％,33.3％,and 33.3％ respectively in 3 days group,and they were 73.0％,67.6％,62.2％,and 62.2％ in 7 days group respectively,and were all 90.3％ in 10 days group.It was showed that the bacteria detection rate in different pipe parts was almost the same with the same change frequency,and the rate was higher with the longer usage of ventilator tube (x2 values were 20.599,19.879,21.975,21.975,all P =0.000).The longer of the tube used time,the higher incidence of VAP.The incidence of VAP in 3,7,10 days groups were 26.7％,59.5％ and 77.4％,respectively,but there was statistically significant difference among all groups (x2 =30.486,P ＜ 0.001).Based on the value of 3 days group,the incidence of VAP in the 7 days group was 15.950 folds of 3 days group,and the incidence of VAP in the 10 days group was 18.333 folds of the 3 days group (both P ＜ 0.001).Conclusion This study suggests that the longer of pipeline using time,the more serious degree of bacterial contamination of pipeline,the higher incidence of VAP.

Objective To observe the effect of moxibustion on Sanyinjiao, Hegu acupoint first active phase of labor contractions pain.Methods One hundred and sixty cases of primipara were divided into test group by single blind, randomized methods (the Sanyinjiao acupoint group, Sanyinjiao acupoint and hegu point group) and control group(non-acupuncturev points group and the blank group).Each group with 40 cases.The patients were exerted mxibustion therapy 30 min in the Sanyinjiao acupoint group and Sanyinjiao acupoint and hegu point group, respectively in the maternal appear regularity uterine contraction pain, after ostium of uterus opened 3 cm.The women of the non-acupuncturev points group were exerted moxibustion therapy in the wrist horizontal stripes of radial side radial pulse place to elbow horizontal stripes biceps tendon of the midpoint of the radial side of attachment 30 min.The blank group women didn' t conduct notcarry moxibustion intervention.On the first active stage of labor time and uterine contraction pain were compared.Results The active labor time of Sanyinjiao group, Sanyinjiao and Hegu group,non acupoint group and blank control group patients were (116.11 ±65.89) min, (81.93 ± 53.45) min, (123.03 ± 7.67) min, (138.69 ± 104.01) min respectively, there was significant difference among Sanyinjiao and Hegu group, non acupoint group and blank group (P＜ 0.05), while the difference between the non acupoint group and blank group without statistical significance (P＞0.05).The first time of production process of 4 groups were (313.22± 141.15) min, (379.50± 182.82) min, (393.00 ±196.50) min, (488.08±236.61) min respectively, there was significant difference among Sanyinjiao group,Sanyinjiao and Hegu group and blank group differences (P ＜ 0.05).Moxibustion therapy after stopping, 2 h degree of cervical dilation of 4 groups were (8.37±2.19) cm, (8.14±2.74) cm, (7.64±2.91) cm, (6.29 ±3.05) cm respectively;contractions lasting time were (0.56±0.16) min, (0.52±0.13) min, (0.:48±0.17) min, (0.41± 0.09) min respectively;uterine contraction interval (2.98± 1.45) min, (2.56± 1.02) min, (3.89 ±1.54) min, (3.41 ± 1.32) min respectively;contraction strength enhaucement efficiency were 60.0％ (24/40) ,75.0％ (30/40), 17.5％ (7/40), 10.0％ (4/40) respectively, there were significant differences among Sanyinjiao group,Sanyinjiao and Hegu group,the non acupoint group and blank control group in terms of above indexes (P ＜ 0.05), while difference between the non acupoint group and blank group without statistical significance(P＞0.05).After the withdrawal of the moxibustion treatment 2 h, the pain reduction in childbirth of 4 groups were 52.5 ％ (21/40), 47.5％ (19/40), 22.5％ (9/40), 20％ (8/40) respectively, the pain reduction in childbirth of Sanyinjiao group, Sanyinjiao and Hegu Point Group were higher than that of non acupoint group and blank group, the differences were statistically significant (P＜0.05);while non acupoint group and blank group compared without statistically significant (P＞0.05).Conclusion The effect of Moxibustion at Sanyinjiao and Sanyinjiao compatibility Hegu Acupoint moxibustion on maternal production process and uterine contraction are significant, but combine with Acupoint Moxibustion can shorten the time of the active phase of labor, increase contraction of the uterus, promote the production process.

Objective To evaluate the performance of BC‐5000 five categories hematology analyzer (BC‐5000) .Methods The background and blank values ,carryover rate ,precision ,accuracy ,trueness ,and linear range were evaluated ,as well as the compara‐bility of its results with reference instrument (XE‐2100) detection and artificial classification of leukocytes .Results The back‐ground and blank values were both qualified .The carryover rates of all the detection items were less than 1% .The intra‐and inter‐precision of all the detection items were good ,and the accuracy and trueness were verified eligibility .The linearity of WBC ,RBC , HGB ,and PLT were good (r>0 .990) .Comparing with XE‐2100 and artificial classification ,Bas% was the only one item with poor correlation coefficient (r=0 .744 ,P>0 .05) .Conclusion BC‐5000 has good performance in hematology detection ,and it is an ideal small five categories hematology analyzer .

Objective The aim of this study was to describe nursing student-patient relationship in Yunnan province,and study its influencing factors and practice effectiveness.Methods The multi-phase stratified cluster random sampling method was adopted to investigate 483 internship nursing students in two first class hospitals in Yunnan province.Results Among 483 nursing students,379 (78.5％) students belonged to facilitative relationship,101 (20.9％) students belonged to authoritative relationship,and 3 (0.6％) students belonged to mechanistic relationship.Sociodemographic data and factors related to three type of relationship showed no statistical significance among three types of nursing students.But student's personal and professional growth,student's increased confidence and self-esteem demonstrated statistical significance among three types of nursing students.In student's personal and professional growth,students of authoritative relationship got the lowest score (3.96±0.78) compared with students of mechanistic relationship and facilitative relationship [(4.17±0.29),(4.17±0.54)],F=4.82,P ＜ 0.01.In student's increased confidence and self-esteem,no significant difference was seen.Conclusions Nursing students' perceptions of student-patient relationship are mostly facilitative.And students' personal and professional growth and confidence and self-esteem increased obviously through internship for students with facilitative student-patient relationship.

Objective To observe the effect of electroacupuncture on onset time and effectiveness of Paroxetine for mild or moderate depression patients and on the scores of Hamilton depression rating scale for depression(HAMD) and self-rating depression scale(SDS). Methods Fifty-five patients with mild or moderate depression were randomly divided into A group( Paroxetine group,29 patients) and B group (Electroacupuncture combining with Paroxetine group,26 patients). Therapeutic periods for the two groups were 6 weeks. HAMD and SDS were used to evaluate the efficacy before the research and after treatment on 1 week,2 weeks,4 weeks,6 weeks.Results HAMD scores and SDS scores for A group were significant difference after 2 weeks treatment compared with the beginning of the research (P＜ 0.05 ) ;HAMD scores and SDS scores for B group were significant difference after 1 week treatment compared with the beginning of the research(P＜0. 05 ). Total effective rate of HAMD for A group was 71.4% ,total effective rate of SDS for A group was 75% ,total effective rate of HAMD for B group was 88% ,total effective rate of SDS for B group was 84%. The total effective rate between the two groups ordered by the individual chi-square test was significant difference( X2 = 4. 1790, P= 0. 0408). Conclusion Electroacupuncture can shorten the onset time and increase the effectiveness of paroxetine for mild or moderate depression patients.

Objective:To identify the immune characteristics elicited by immunogen prepared in two different ways against a 36AA-peptide. Methods：Rabbits were immunized by a 36-AA-hapten coupled with carrier proteins or recombinant fusion protein separately. The kinetics and specificities of antibody responses were compared. Results：After about 3 months of primary immunity, the antisera elicited by two kinds of immunogen reached the peak titer. The highest titer elicited by the immunogen prepared with coupled-hapten method reached 1∶12 000, while the highest titer elicited by the immunogen prepared with gene engineering method was 1∶6 000. But the immune response produced by the recombinant fusion protein was more long-lasting. Conclusion：Both kinds of immunogen can successfully elicit 36-AA specific antibody response in rabbits, which have different immune characteristics. To couple the hapten with vector proteins is a quicker and more effective way to prepare the immunogen.

Objective : To understand the epidemiological characteristics of intentional injury cases in Jiaxing from 2009 to 2016,and to provide basis for prevention and control of intentional injury. Methods: Data from the injury surveillance hospitals in Jiaxing from 2009 to 2016 were collected to learn the distribution and trend of gender,age,injury intention,cause,occurrence place,injured body parts and severity in intentional injury cases. Results: There were 8 089 cases of intentional injury reported by injury surveillance hospitals in Jiaxing from 2009 to 2016,accounting for 3.40% of all injury cases reported（237 912）. A total of 7 489 cases aged between 15 to 64 years old,accounting for 92.58%. There were 6 906 cases of violence and 1 183 cases of suicide or self-inflicted injury,accounting for 85.38% and 14.62%,respectively. The male-female ratio in the cases of violence was 2.54∶1,while the one in the cases of suicide or self-inflicted injury was 1∶1.59. The cases of violence was mainly caused by blunt instruments,accounting for 75.17%（5 191 cases）,while the cases of suicide or self-inflicted injury was mainly caused by poisoning,accounting for 47.76%（565 cases）. The cases of violence mainly occurred in streets,accounting for 29.64%（2 047 cases）,while the cases of suicide or self-inflicted injury mainly occurred at home,accounting for 82.59%（977 cases）. Head was the main injured parts in the cases of violence,accounting for 66.81%（4 614 cases）,while digestive system was the main injured parts in the cases of suicide or self-inflicted injury,accounting for 31.45%（372 cases）. About 0.12% of cases of the violence and 1.44% of cases of suicide or self-inflicted injury caused to death. Conclusion Intentional injury cases in Jiaxing were mainly young or middle aged people. Violence was a common intention of injury in males and suicide or self-inflicted injury was a common intention of injury in females.