BACKGROUND:Medical risks are al unsafe events or that damage to the patient during medical services. Present medical risk management is mainly qualitative experience, and lacks of regular failure analysis and risk assessment for established medical treatment.
OBJECTIVE:To construct models of medical process failure analysis and risk assessment, find possible risks during medical treatment, and propose effective measures to eliminate or decrease above risks.
METHODS:Failure mode and effects analysis during reliability engineering were used in production. That was, risk assessment was conducted in the possible technical failure modes, causes and al impacts on the product during each process. Improvement measures were made for weak link during the process. The risk could reach an acceptable level. In accordance with failure mode and effects analysis during production, the procedure of medical process failure analysis and risk assessment could be made to analyze the potential failures during medical treatment. Moreover, the improvement measures were proposed for weak link with high risks so as to prevent the occurrence of risk of significant adverse effects on patients.
RESULTS AND CONCLUSION:The methods and basic procedures of medical process failure analysis and risk assessment were established by using the experience of failure mode and effects analysis. Taking the rescue process of myocardial infarction in the emergency of a hospital as an example, the analysis of failures, reasons and impacts was performed taking“chewing 300 mg aspirin”in the rescue steps as a key. The improvement measures and suggestions were proposed for unacceptable failures and reasons. Seen from the analysis results, proposed improvement measures and suggestions can obviously decrease the risks of failures caused by this step to patients. Therefore, the application of failure mode and effects analysis in medical treatment has a strong practical value.

OBJECTIVE:To optimize the approach and methods for the selection of national essential drugs and to improve national essential drug system.METHODS:The concept of national essential drugs and the principle of selecting national essential drugs and the problems within were expounded,and the rationale and methods of pharmacoeconomics were adopted to analyze its significance and role in selecting national essential drugs.RESULTS & CONCLUSION:Simplifying National Essential Drug List can facilitate peoples’ access to essential drugs.

Objective To explore the effectiveness of defluoridization of water and the morbidity trends in endemic fluoroais areas in Yanqing county of Beijing, in order to provide the basis for the formulation of prevention and control measures. Methods In 2008, stratified random was used to collect water samples to detect the amount of drinking water fluoride in three villages(Gujiaying, Bojiying and Hujiaying) in Yanqing county using ion-selective electrode in both dry and rainy seasons. Sixty-three students in 8 - 12 years old and 664 adults over 16 years of age were determined of urinary fluoride, and examine the prevalence of dental fluorosis. ResultsThe fluorine content in drinking water in the dry and rainy seasons was (0.72 ± 0.12), (0.76 ± 0.18)mg/L, respectively. The median of fluorine content in urine of children was 1.11 mg/L with the range of 0.32 - 4.15 mg/L; the median of fluorine content in urine of adult was 1.42 mg/L with the range of 0.37 - 4.65 mg/L. The detection rate of dental fluorosis in children was 23.81%(15/63), dental fluorosis index was 0.45; the detection rate of dental fluorosis in adult was 54.97% (365/664), dental fluorosis index was 1.70. Conclusions Fluorine content in drinking water meets the national standard in Yanqing county. The morbidity of endemic fluorosis descends in some extent in a result of defluoredization.

Objective To understand current status of brucellosis infection in both human and animal in Yanqing County to get solid scientific basis for controlling the disease and to prevent the spread of epidemic.Methods Cluster sampling method was used in this survey in stock raisers and ELISA and SAT were performed to inspect serologic antibody of Brucella.At the same time an epidemic investigation was carried out,including the basic personal situation,occupational history,vaccination history,clinical symptom,and so on.Resutls In a total of 216 cow raisers whose blood Was detected,27 cases showed positive in titer test of Brucella antibody with a ratio of 12.50%.However,all the antibody carriers did not have any clinical symptoms.In all 2185 cows that were collected for antibody test,1488 cases had positive serological antibody with a ratio of 68.10%.And all the positive COWS also did not have any clinical symptoms.Conclusions The subclinical infection of brucellosis is rather high in Yanqing County's stock raisers.It is self-protection of the stock raisers,epidemic knowledge propaganda,serological surveillance in human and animal,immunize of healthy cows,and eliminate of diseased cows that are urgent in order to keep the public in health.

In the riboflavin fermentation by recombinant Bacillus subtilis 24/pMX45,The yeast powder facilitate riboflavin biosynthesis and the yeast extract have negative effect. It was found that the concentrations of inorganic ions and the amino acids in yeast extract were much higher than that of the yeast powder. The inorganic ions and the amino acids were respectively added to the medium while yeast powder was used as base nitrogen source. The fermentation results show that excess inorganic ions and glutamine have negative effect on riboflavin biosynthesis. The yeast extract restrained riboflavin biosynthesis for it contains much glutamic acid.

Cardiomyopathy, Dilated ; etiology ; pathology ; therapy ; Humans ; Myocardium ; pathology

BACKGROUND:According to the theory of Traditional Chinese Medicine, stimulating certain acupoints of the body after exercise may improve its antioxidant capacity, but different acupoints have different effects. OBJECTIVE:To compare the effect of different acupuncture combinations on the antioxidant capacity of myocardial and liver tissues in rats after exhausted swimming exercise, and screen out the optimal acupoint combination for exercise-induced fatigue. METHODS:Seventy Sprague-Dawley male rats were divided into five groups: control group (n=10), model group (n=15),Sanyinjiao +Zusanli group (n=15),Shenshu +Zusanli group (n=15),Dazhui+Zusanli group (n=15). Except the control group, rats in the other four groups were subject to exhausted swimming. In the three acupuncture groups, rats were given acupuncture at corresponding acupint combinations at 15 minutes after exercise. RESULTS AND CONCLUSION:Compared with the control group, the activities of superoxide dismutase and glutathione peroxidase in the myocardial and liver tissues were significantly reduced in the model group, while the malonaldehyde content in cardiac muscle was significantly increased. Compared with the model group, the activities of superoxide dismutase and glutathione peroxidase in the cardiac muscle were significantly increased inSanyinjiao +Zusanli group, the superoxide dismutase in liver tissue was significantly increased inShenshu+Zusanli group, the malonaldehyde content in the myocardial tissue was significantly decreased in Sanyinjiao +Zusanli group and Dazhui +Zusanligroup, the malonaldehyde content in the liver tissue was significantly decreased in Sanyinjiao +Zusanligroup. Different acupuncture combinations have different effects on the activities of superoxide dismutase and glutathione peroxidase, as wel as the malonaldehyde content in the myocardial and liver tissues of fatigued rats. Acupunture could increase the antioxidant ability in cardiac muscle of rats and the best combination might beDazhui+Zusanli; acupoint combinations ofShenshu +Zusanli andSanyinjiao +Zusanli are specific for liver tissue.

Objective To explore the effect of insulin injection and protamine biosynthetic human insulin injection on basal insulin level in pregnant women with diabetes mellitus.Methods Retrospective analysis of 89 cases of pregnant women with diabetes mellitus from January 2013 to May 2016 in department of obstetrics and gynecology,tianjin red bridge hospital,the patients were divided into group A (n=38 cases) and group B (n=51 cases),the group A treatment with insulin injection,the group B treatment with protamine biosynthetic human insulin injection,compare the two groups of patients before and after treatment of three meals a day rate of blood glucose compliance, treatment compliance and satisfaction.Results Before treatment, there was no significant difference in the blood glucose compliance rate between the two groups before and after treatment;After treatment,the blood glucose compliance rate of two groups was significantly higher than before treatment ( P<0.05 ) , there was no significant difference in the compliance rate of fasting blood glucose between two groups,the compliance rate of blood glucose before dinner in group A was 81.58%,significantly higher than that in group B 60.78%(P<0.05).Conclusion Both insulin injection and protamine biosynthetic human insulin injection can maintain the basic insulin levels of pregnant women with diabetes mellitus,insulin injection can better control the blood glucose levels before dinner,with higher compliance and satisfaction.The compliance rate and satisfaction rate of pregnant women in group A were 97.37% and 97.37%,which were significantly higher than those in group B 82.35% and 80.39%(P<0.05).

Objective: To establish an HPLC method for the determination of three bacteriostatic agents ( methylparaben, eth-ylparaben, propylparaben) in taurine eye drops. Methods:The HPLC method was conducted on a Phenomenex Gemini C18 column ( 250 mm × 4. 6 mm, 5 μm ). The mobile phase was 1％ acetic acid-methanol(40 :60). The flow rate was 1. 0 ml·min-1 and the de-tection wavelength was 254 nm with the injection volume of 20 μl and the column temperature of 25℃. Results:Methylparaben, eth-ylparaben and propylparaben showed good linear relationship (r>0. 999)within the range of 1. 00-19. 94μg·ml-1,2. 01-20. 08μg· ml-1 and 0. 21-10. 46 μg·ml-1,respectively. The average recoveries were 99. 20％-99. 90％, and the RSDs were 1. 34％-1. 54％(n=9). Conclusion:The method is accurate, reproducible and stable without interference, which can be used for the determination of three bacteriostatic agents in taurine eye drops.

Objective To observe the clinical efficacy of treating congestive heart failure with the combination of Astragalus,Danhong and Nitroglycerin injection.Methods 73 cases with congestive heart failure were selected.randomly recruited into a control group and a treatment group.The control group was treated with conventional therapy,and the treatment group was treated with Astragalus injection,Danhong and nitroglycerin injection on the basis of conventional mompy.Both groups were treated for one course of therapy of 21 days.Such indexes as clinical signs and symptoms,cardiac function,the amount of output per bo(SV),each sub-output(CO),cardiac index(CI),left ventricular ejection fraction(EF),and blood the rheology were observed before and after the treatment.Reselts The total effective ratewas 97.29%and 88.89%in the treatment group and the control group respectively,showing statistically differences between the two groups(P＜0.05):SV CO,CI and EF showed significant difference in both groups after the treatment(P＜0.01 or P＜0.05),and significant difference between the two groups(P＜0.05).Blood theology wag decreased after the treatment,and such clecreasing in the treatment was greater than that in the control group(P＜0.01).Conclusion The combination therapy of astragalus,Danhong injection and nitroglycerin injection is effective in treating congestive heart failure.