Self-made molecule imprinting polymer-solid phase extraction column was used in extracting nerve agent degradation products in rice. The extraction was then examined by capillary electrophoresis. The method was simple, reliable and sensitive. The calibration curve showed a good linearity for the nerve agent degradation products in rice was in the concentration range of 0.2～5.0　μg/g and the detection limits were 0.05μg/g. The RSD of the method was less than 6.2%.

Objective? To investigate the current situation of intravenous therapy in 38 ClassⅡ and above hospitals in Hu'nan Province and analyze the existing problems. Methods? A questionnaire survey was conducted in 38 hospitals in Hu'nan Province in November 2018 using the Nursing Situation of Intravenous Therapy in Hospitals at All Levels designed by the Professional Committee of Intravenous Therapy and Chinese Nursing Association. To understand the status quo of intravenous therapy, quality management of intravenous therapy, and the status of specialist nurses in intravenous therapy. Results? In 38 hospitals, totally 36 hospitals provided continuous intravenous therapy services through intravenous therapy/peripherally inserted central catheter (PICC) clinics and a designated hospital department; 21 hospitals had established intravenous therapy/PICC clinics; the outpatient service was flexible in form, but the qualification certification of outpatient nurses needed further regulation. The proportion of hospitals carrying out medium and long-term catheter infusion and hospitals carrying out PICC transfusion with Modified Sedinger Technique (MST) puncture guided by ultrasound was 100.00% and 72.22%, respectively. In vascular visualization technology, hospitals using infrared, ultrasound and X-ray technology were 2.63%, 63.16% and 34.21% respectively. There were some gaps in the skin disinfectant and disinfection scope, concentration of flushing and sealing fluid and maintenance frequency between the hospitals and the national standards in peripheral and central venipuncture and catheter maintenance. In terms of quality management of intravenous therapy, 34 hospitals had established intravenous therapy teams, whose quality evaluation criteria are different. In terms of specialist nurses team construction, there were 505 specialist nurses in venous therapy/PICC in 38 hospitals. The structure of specialist nurses had been continuously optimized in terms of education, title and length of service. However, hospitals needed to pay more attention to the development of specialist nurses. Conclusions? The contents of continuous nursing of intravenous therapy need to be further expanded, the management of PICC clinic needs to be strengthened, the standardized use of infusion devices and connectors needs to be improved, the knowledge and practice gap between puncture nursing and catheter maintenance of intravenous therapy exists, and the quality control standards of hospitals need to be standardized and regulated, more attention should be paid to the development of specialist nurses.

Objective:To establish the content of training courses for infusion therapy specialist nurses, and evaluate the implementation effect of the course, so as to provide a theoretical reference for the training of infusion therapy specialist nurses.Methods:Based on the preliminary investigation research on the needs of nurses for the training of intravenous therapy knowledge, the Delphi method was used to determine the training content of 6 modules and 62 projects. From March to May and from September to November 2019, two training sessions were carried out at the vascular access technology training base in Hunan Province. A total of 97 nurses from 84 hospitals participated in and completed the theoretical and practical courses, and the number of students in the two training sessions were 46 and 51 respectively. The learning effect of the students was understood with the pass rate of the staged assessment, the pass rate of the graduation assessment and the self-evaluation questionnaire.Results:The 97 students' self-evaluation of the mastery of learning content was 3.30 to 5.00. In the staged assessment, the theoretical score was (87.50±4.48) , the peripherally inserted central catheter (PICC) maintenance operation score was (86.25±5.62) , the infusion port maintenance score was (89.50±6.25) , and the PICC catheterization operation score was (84.42±4.13) . The qualification rate of theoretical and operational assessment was both 100.0%. In the graduation assessment, 97 students all completed the graduation assessment requirements, a total of 4 941 indwelling needles were successfully placed, 509 PICCs were successfully placed, and 97 small lectures were completed. The graduation assessment pass rate was 100.0%.Conclusions:This course has a high degree of expert positivity, expert authority and coordination of expert opinions, and the curriculum setting is scientific. The training course promotes the students' mastery of the specialized knowledge theory and practical skills of intravenous therapy, and can provide a theoretical basis for the training of intravenous therapy specialist nurses in my country.

Objective:To develop the Peripherally Inserted Central Catheter (PICC) Nursing Knowledge, Attitude and Practice Scale for Primary Caregivers of Patients with PICC, and to test its reliability and validity.Methods:Taking the theory of knowledge, attitude and practice as the basic framework, the item pool was initially constructed through literature review, group discussion, and semi-structured interviews from March to April 2021. From May to July 2021, the initial scale was formed through Delphi expert consultation, and the items of the scale were pre-tested and adjusted through cognitive interviews. From June to October 2021, convenience sampling was used to select the primary caregivers of 450 patients with PICC in a cancer hospital in Hunan Province for a formal survey to test the reliability and validity of the scale.Results:The formal scale consisted of 53 items in 3 dimensions, including 19 items in the knowledge dimension, 8 items in the attitude dimension, and 26 items in the practice dimension. The Cronbach's α coefficients of each dimension and the total scale were 0.949, 0.962, 0.972, and 0.981, respectively, and the test-retest reliability coefficients of each dimension and the total scale were 0.951, 0.935, 0.972, and 0.967, respectively. The split-half reliability coefficients of each dimension and the total scale were 0.889, 0.954, 0.889, and 0.882, respectively. The content validity index of the item ranged from 0.82 to 1.00.Conclusions:The reliability and validity of the PICC Nursing Knowledge, Attitude and Practice Scale for Primary Caregivers of Patients with PICC is good, and it can be used as a tool to evaluate the PICC nursing knowledge, attitude, and practice of primary caregivers of patients with PICC.

Objective:To explore the effect of healthcare failure mode and effect analysis (HFMEA) management mode on perioperative nursing quality of cancer patients at arm infusion port.Methods:Using the convenient sampling, 68 cancer patients with arm infusion port in Hunan Cancer Hospital from January to October 2020 were selected as the control group, and 84 cancer patients with arm infusion port from November 2020 to August 2021 were selected as the intervention group. The control group followed the hospital's original perioperative safety management of chest wall port and peripherally inserted central catheter (PICC) insertion, while the intervention group adopted the HFMEA management mode for the perioperative safety management of arm infusion port. The risk priority number (RPN) , the occurrence of high-risk failure modes and complications of the two groups were compared.Results:The RPN values of failure modes such as inadequate preoperative evaluation, loss of intraoperative accessories, low puncture position, too short catheter clipping, loose connection between catheter and injection base, catheter positioning after incision suture, and insufficient postoperative health education in the intervention group were lower than those in the control group, with statistical differences ( P<0.05) . The incidence of inadequate preoperative evaluation, inadequate postoperative health education and postoperative complications in the intervention group were statistically lower than those in the control group ( P<0.05) . Conclusions:The HFMEA management mode can reduce the risk of perioperative links of cancer patients at arm infusion port and decrease the incidence of postoperative complications, which is worthy of clinical promotion.

Objective:To explore the central venous catheter maintenance compliance among nurses in Class Ⅱ and Ⅲ hospitals in Hunan Province.Methods:From January to March 2022, 297 nurses from 22 Class Ⅱ and Ⅲ hospitals in Hunan Province were selected as the research subject by convenience sampling. Nurses were surveyed using the self-made Central Venous Catheter Maintenance Compliance Questionnaire. Multiple linear regression was used to analyze the influencing factors of nurse compliance with central venous catheter maintenance, the items of the Central Venous Catheter Maintenance Compliance Questionnaire were analyzed.Results:A total of 297 questionnaires were distributed, and 268 valid questionnaires were collected, with an effective response rate of 90.24%. The hospital level, specialized training in intravenous therapy, and age were the influencing factors on the compliance of nurses with central venous catheter maintenance. Analyzing specific items, only 34.3% (92/268) of nurses correctly executed the item "alcohol cotton pads were recommended", and only 66.4% (178/268) of nurses correctly performed the item "sterile gauze dressings should be replaced at least every two days".Conclusions:There is a certain gap in the central venous catheter maintenance compliance among nurses at all levels of hospitals, and there is a need to improve compliance in disinfection of infusion joints and replacement of sterile gauze dressings. We should strengthen the training of specialist nurses, especially the training of nurses in ClassⅡ hospitals on specialized skills related to intravenous therapy.

Objective: To investigate the value of short tandem repeat (STR) genotyping in the diagnostic workup of molar and non-molar gestations with correlation of histological characteristics. Methods: Six hundred and fifty-six cases were selected based on clinically suspected hydropic abortion and/or molar pregnancy from July 2015 to September 2017 at Beijing Obstetrics and Gynecology Hospital. DNA was extracted from dissected chorionic villi and paired maternal endometrial FFPE tissue samples by Simplex OUP™ FFPE DNA Tissue Kit. STR genotyping was performed by PowerPlex 16 HS system. Results: DNA genotyping was informative in 649 of 656 cases, leading to identification of 215 hydatidiform mole gestations and 434 non-molar gestations. Most of non-molar gestations (375 cases, 86.4%) were diploid hydropic abortion. Various trisomy syndromes were found (53 cases, 12.2%), including trisomy 2, 3, 4, 7, 8, 13, 16 and 21. Only 2(0.5%) digynic triploid gestations were detected. Moreover, 4 cases (0.9%) of uniparental disomies (homologous or heterologous) were found. There were 196 cases with histologic diagnostic suspicious of hydatidiform moles were accurate sub-classified. Among them, 59 cases hydatidiform moles were under-diagnosed as diploid hydropic abortions, and 28 cases diploid hydropic abortions were over-diagnosed as hydatidiform moles.Compared with partial moles(PHM), there were no specific histomorphological features between the various types of non-molar gestations and partial moles for definitive diagnostic separation. There was no significant difference in the expression of p57^kip2 among PHM, trisomy and diploid hydropic abortions group (P=0.247). Conclusions STR genotyping can distinguish non-molar gestations from early hydatidiform moles, and efficiently avoid misdiagnosis based only on histological evaluation. Therefore, using STR genotyping, not only can the overdiagnosis of non-molar pregnancy be avoided, but also individualized management can be offered to patients including monitoring of serum hCG.

Objective To evaluate the effects of"PICC fixed standard operation flow chart"in PICC fixed quality management. Methods Patients with PICC were admitted to the control group from January to June in 2014, given the routine PICC fixed method. PICC patients in the observation group who were enrolled from July to December 2014 were given new PICC fixed method that obey the"PICC fixed standard operation flow chart", which was established from relevant norms and guidelines and related literature. The incidence rate of medical adhesive related skin injury and unplanned extubation of PICC were compared with those of the two groups. Results The incidence rate of medical adhesive related skin injury was decreased from 35.20％(70034/198962) to 18.03％(37862/209955) (Z=-3.363, P<0.01) and PICC unplanned extubation decreased from 1.31‰(20/15384) to 0.37‰(7/18919) , the difference was statistically significant (χ2=6.940, P<0.05). Conclusions The PICC fixed standard operating flow chart can be used as a guide to implement the PICC fixation. Based on this, the quantitative management index is applied to the PICC fixed quality management, which can standardize the fixation of the PICC , reduce the related complications caused by the fixation of the catheter, prevent the occurrence of unplanned extubation of PICC , provide effective protection to ensure safe PICC long-term use and improve the patient's comfort.

Objective: To investigate the frequency of KRAS mutation in mucinous epithelial lesions of the endometrium, and analyze the correlation between KRAS mutation and the clinicopathologic features. Methods: The cohort included forty-three cases of mucinous epithelial lesions of the endometrium selected from July 2015 to October 2017 from Beijing Obstetrics and Gynecology Hospital, and 22 control cases. Genomic DNA was extracted from formalin-fixed paraffin-embedded tissue sections. Polymerase chain reaction amplification for KRAS exons 2 and 3 was performed, followed by sequencing using capillary electrophoresis. The Fisher exact test was used to compare the prevalence of KRAS mutation among the different groups. Results: The patients′age ranged from 33 to 77 years [mean (55.12±9.34) years, median 55 years]. None of the eight cases of endometrial hyperplasia with mucinous differentiation without atypia showed KRAS mutation. The frequency of KRAS mutations was 1/10 in endometrial atypical hyperplasia, 1/12 in endometrioid carcinoma, 4/11 in endometrial atypical hyperplasia with mucinous differentiation (EAHMD), 6/15 in endometrioid carcinoma with mucinous differentiation (ECMD) and 8/9 in mucinous carcinoma (MC), respectively. The differences were statistically significant between MC versus EC (P<0.01) and MC versus ECMD (P<0.05). Conclusion The high frequency of KRAS mutation in EAHMD, ECMD and MC indicates that KRAS mutational activation is implicated in the pathogenesis of endometrial mucinous carcinoma.

OBJECTIVETo investigate the clinical utility of short tandem repeats(STR) genotyping technique for diagnosis of partial hydatidiform moles (PHM).

METHODSTen cases with the original diagnosis of PHM and six cases diagnosed as "favour PHM" or "abnormal villous, PHM not excluded" were selected for the study. The clinical information and follow-up data were reviewed. Histopathologic features were evaluated along with p57 immunohistochemistry. After DNA extraction from each sample, genotyping was performed by AmpFlSTR(®) Identifiler™ PCR kit to amplify 15 STR polymorphism loci plus the amelogenin gender-determining in a single robust PCR.

RESULTSThe age of patients ranged from 18 to 49 years (mean=29 years, median=29 years). Two villous populations (7/16), irregular villous contour (13/16), at least moderate trophoblastic hyperplasia (2/16), cistern formation (8/16), syncytiotrophoblastic knuckles (14/16), trophoblastic pseudoinclusions (6/16) and nucleated fetal red blood cells (8/16) were presented in these cases. Of the cases in the study, STR genotyping identified 4 monospermic complete hydatidiform moles (MCM), 3 dispermic partial hydatidiform moles (DPM) and 9 hydropic abortions (HA). The misdiagnosis rate was 13/16 only relied on morphology evaluation. Immunostaining of p57 showed 3/4 of MCM were focally positive (<5%-20%+), 1/4 of MCM were diffusely positive (70%+), 3/3 of DPM were diffusely positive (≥50%+), 7/9 of HA were diffusely positive (≥50%+), and 2/9 of HA were focally positive (10%+).

CONCLUSIONSCombination of histomorphologic evaluation and p57 immunostaining is insufficient for a definitive diagnosis of PHM. STR genotyping offers an accurate diagnosis of PHM.

Abortion, Spontaneous ; Adolescent ; Adult ; Cyclin-Dependent Kinase Inhibitor p57 ; metabolism ; Female ; Genotype ; Genotyping Techniques ; Humans ; Hydatidiform Mole ; diagnosis ; genetics ; Immunohistochemistry ; Microsatellite Repeats ; Middle Aged ; Polymerase Chain Reaction ; Pregnancy ; Trophoblasts ; pathology ; Uterine Neoplasms ; diagnosis ; genetics ; Young Adult