With the implement of inverted burden of proof,the work of clinical practice and teaching faces challenge. At present, more aspects of clinical medicine and practice teaching are not suitable for the new rule, and they have affected and restricted the improvement of quality of clinical practice teaching. It is necessary for interns and clinical tutors to study the new rule and suit its demands. Only in this way can the quality of clinical medicine, teaching and practice be improved.

Objective To discuss the application effect of FMEA in reduction of unplanned extubation of PICC.Methods FMEA was applied to find out the failure mode of unplanned extubation of PICC,and then assessed it from three dimensions,which were the likelihood of occurrence,the possibility of being discovered,and the seriousness of the failure,and then calculated the RPN values,risk priority,and plan optimization process,at the last made a proactive behavior intervention.81 patients were selected as the control group before the application of FMEA and 98 patients were set as the experimental group after the application of FMEA.The incidence of unplanned extubation was compared between two groups.Results There was statistically significant difference in unplanned extubation between two groups.Conclusions Application of FMEA can reduce the rate of unplanned extubation of PICC.

OBJECTIVE:To define the basic elements clinical pharmacists should possess in clinical treatment team.METHODS:The purpose of setting clinical pharmacists system was investigated.Different working scope and different professional requirements of clinical pharmacists and physicians were explored.The basic elements clinical pharmacists should possess in clinical treatment team were found out.RESULTS&CONCLUSION:Clinical pharmacist system of our country is a significant progress of the hospital clinical system.Clinical pharmacists in the clinical treatment team must have four basic elements:clinical responsibility,clinical action,clinical ability and clinical effect.Only in this way,could clinical pharmacists in the clinical treatment team become an irreplaceable part.

[Objective] To observe the effects of Niaoduling Granule (NG) on renal function in rats with chronic renal failure (CRF) and its relationship with renal transforming growth factor (TGF) ?1. [Methods] CRF rat models were established by 5/6 subtotal nephrectomy and then the model rats were randomized into model group (Group B), NG group (Group C) and placebo control group (Group D) and other 8 rats served as mimic operation group (Group A) . Biochemical indexes, metabolic parameters and pathological features in kidney were examined and expression of renal transforming growth factor (TGF) ?1 was determined by immunohistochemical assay. [Results] Renal hypofunction, disorder of electrolyte, decrease of hemoglobin and CRF features were found in Group B. After treatment, renal function was improved and glomerulus-sclerosis index (GSI) and expression of renal TGF ?1 were decreased in Groups C and D (P

Communicable Disease Control ; Humans ; Influenza, Human ; prevention & control ; World Health Organization

Antibodies, Monoclonal ; therapeutic use ; Cell Transformation, Neoplastic ; Dexamethasone ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Glucocorticoids ; therapeutic use ; Humans ; Immunosuppressive Agents ; therapeutic use ; Lichen Planus, Oral ; diagnosis ; pathology ; therapy ; Phototherapy ; Prednisone ; therapeutic use ; Recombinant Fusion Proteins ; therapeutic use

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BACKGROUND: Changes of leukocytes are related with some postoperative complications after renal transplantation. OBJECTIVE: To observe dynamically the level of white blood cell (WBC) and its morphological changes using automatic blood cell analyzer to evaluate its relationship with infection, immunosuppressive intoxation and acute rejection. DESIGN, TIME AND SETTING: Observation and controlled trial was performed at Second Xiangya Hospital, Central South University from June 2004 to October 2005. PARTICIPANTS: Sixty-eight patients who received renal transplantation were selected. According to clinical symptoms and laboratory biochemical indexes, X-ray, B ultrasound, and renal puncture biopsy, the patients were divided into stable group (n=36), infection group (n=9), intoxation group (n=6) and acute rejection group (n=13). METHODS: The blood routine was tested with Sysmex XE-2100 automatic blood analyzer following renal transplantation and WBC manual differentiation was done to observe peripheral blood morphology, their liver function. In addition, renal and liver functions were detected by automatic biochemical system 7600A. MAIN OUTCOME MEASURES: WBC count and its morphological changes in peripheral blood and liver and renal function after renal transplantation. RESULTS: WBC count of the stable group and intoxation group was normal, and that of the acute rejection group and infection group were significantly higher than the stable group (P

Objective To introduce the technique and efficacy of the treatment of avulsion fracture at tibial insertion of anterior cruciate ligament(ACL) in children through internal fixation by hollow cancellous bone screw under arthroscope.Methods December 2002 ～December 2007,internal fixation using percutaneous reduction by leverage was conducted in 68 children with avulsion fracture at tibial insertion of ACL in our hospital.In 68 children,there were 29 females and 39 males,aged 6～15 years(average age of 12 years),including 22 cases of typeⅡ(with limited knee extension)and 46 cases of type Ⅲ.The fracture was fixed by hollow titanium cancellous bone screw.Results Sixty eight cases were followed up for an average of 18 months(12～36 months).The muscle tension(mea sured by KT-2000) in injured side was recovered close to the uninjured side.Excellent reduction,solid inter nal fixation,complete healing,stable knee joint and negative Lachman and drawer tests were shown in this clinical setting.No swelling,pain and knee dysfunction were found.Impingement sign at intercondylar fossa disappeared.The patients were satisfied with their functional recovery.There was no abnormal angulation and shortness.Conclusion Treatment of avulsion fracture(type Ⅱ with limited knee extension or type Ⅲ) at tibial insertion of ACL by arthroscopic internal fixation with hollow titanium alloy cancellous bone screw could obtain accurate and reliable reduction,and avoide epiphysis injury with satisfactory functional recovery.