Errors and flaws of clinical nursing practice can be fully exposed to voluntary reporting system of nursing errors, and then dramatically improving patient safety. This paper aims at exploring the theoretical basis, the characteristic of the system and essentiality for establishing voluntary reporting system of nursing errors, introducing the methods practicing both in abroad and in domestic, explaining its precondition and put forward a suggestion that the voluntary reporting system would be established in our own country.

Objective To evaluate the efficacy and safety of InVance bulbourethral sling for stress urinary incontinence after radical prostatectomy.Methods Six male patients with stress urinary incontinence after radical prostatectomy were treated with perineal sling (InVance) from March 2005 to March 2011,and the clinical data were analyzed.Results The operation time was 80-120 min and intra-operative blood loss was 20-50 ml.The catheter was removed at the second day after surgery.In a follow-up of 12 to 29 months,4 patients were dry,1 patient was improved,and 1 patient suffered treatment failure.There were 2 patients transient acute urinary retention and 1 patient short-term perineal pain in the main post-operative complication.In six months after the operation,urodynamic examination showed (15.9 ± 7.7) ml/s at Qmax and 0-20 ml/s at postvoid residual.Conclusion InVance bulbourethral sling for the treatment of stress urinary incontinence after radical prostatectomy appears to be safe,simple in the procedure and good effect to mild and middle incontinence.

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) as common seed cells have been widely used in tissue-engineered cartilage repair.OBJECTIVE: To use human amniotic membrane as a cell scaffold to carry rabbit BMSCs in order to repair articular cartilage defects in the femoral intercondylar fossa of rabbits.METHODS: Rabbit BMSCs were inoculated onto the human acellular amniotic membrane (HAAM) and co-cultured for 2 weeks. Articular defect models were made in the femoral intercondylar fossa of rabbits. The defects of the right knees served as blank control. BMSCs/HAAM composite was transplanted into the defect of the left knee joint as composite group, and HAAM was implanted into the defect of the left knee joint as HAAM group. These rabbits were killed at 8 and 12 weeks after implantation and the newly cartilage samples were evaluated grossly and histologically and then graded.RESULTS AND CONCLUSION: Gross observation showed the defects were filled with cartilaginous tissues in the composite group, and there were no cartilage tissues in the HAAM group, while only fibrous tissues were seen in the blank control group. Histologically, the defect region was full of chondrocytes in the composite group,immunohistochemistry staining indicated that collagen II was rich in the tissue, and furthermore, the cartilage matrix was stained deeply by toluidine blue. In the the HAAM group, there were few chondrocytes, toluidine blue staining was weakly positive, and immunohistochemistry staining was negative, indicating there was no cartilage matrix. In the blank control group, the defects were filled of fibroblasts and toluidine blue staining was weakly positive. To conclude, the BMSCs/HAAM is a good scaffold for BMSCs chondrogenic differentiation to effectively repair articular cartilage defects.

Objective To investigate the effects of different abstinent duration on brain functional network of heroin addicts at resting state.Methods Sixteen heroin addicts during protracted abstinence for 11-13 months (PA12 group) and twenty heroin addicts during protracted abstinence for 5-7 months (PA6 group) were recruited in the resting-state functional MRI study.Graph theoretical methods were applied to construct topological organization of whole brain network and nodes betweenness of the networks in all subjects,and the between-group differences were analyzed.The correlation of the node betweenness with the abstinence duration was conducted.Results There was no significant difference (P＞0.05) in the small world characteristic (γ≈1,λ》1) between two groups.Compared with the PA6 group,the PA12 group demonstrated significantly decreased nodal betweenness in regions of left parahippocampal gyrus,left precentral gyrus,and significantly enhanced nodal betweenness in regions of the left cuneus,left temporal and right middle occipital gyrus (all P＜0.05).Moreover,the betweenness of the left precentral gyrus (r =-0.52,P =0.001) and parahippocampal gyrus (r=-0.49,P=0.002) were negatively related with the abstinence duration,the betweenness of the right middle occipital was positively correlated with the abstinence duration (r=0.49,P=0.003).Conclusion The brain network small world topology of heroin addicts tend to be stable after 5-7 months of abstinence.Long-term abstinence may minimize the addicfs memory of drugs and potential drug seeking behavior,and recover addicts' visual spatial attention function.

PurposeHeroin addiction is a chronic and recurrent functional brain disease, there are some functional changes in specific brain regions, but the network character remains unclear. The aim of this paper is to explore the network character of brain resting-state functional network in heroin addicts, to identify the potential neuromechanism of heroin addiction from the perspective of brain network.Materials and Methods Thirty heroin addicts (HA group) and twenty-nine healthy controls (control group) underwent resting-state functional MRI scanning using GE 3.0T MRI scanner. The brain functional networks were constructed based on graph theory, the small-world properties and node properties were calculated and compared between the two groups, the correlation between the total dosage of heroin and node degree was analyzed.Results Compared with control group, the small world characteristics of HA group was altered with statistically significant difference (P<0.05, corrected by false discovery rate); the node degrees in orbit frontal regions increased, while those in occipital brain regions decreased (P<0.05, corrected by false discovery rate). No correlation was found in HA group between node degree and the total dosage of heroin.Conclusion These results suggest that topology of functional brain networks were altered in heroin addicts which tends to random networks; increased motivational driving to the salience of drug and decreased visuospatial attention in heroin addicts may provide a strategy for identifying the neuromechanism of heroin addiction.

Objectives To summarize the clinical characteristics of imported falciparum malaria patients and the treatment so as to provide the evidences for improving the diagnosis and treatment of the disease. Methods A total of 138 imported falci?parum malaria patients who received the treatment in Shandong Institute of Parasitic Diseases from January 2007 to February 2013 were adopted as the observation subjects and their clinical data were collected and analyzed. Results All the 138 pa?tients were back from African countries. The main manifestations were fever headache asthenia and hepatosplenomegaly and most of them were with decreased RBC PLT levels and increased LDH levels and 36.96%of them were misdiagnosed as respiratory diseases nephritis hepatitis and so on. Through antimalarial treatment of artemether or artesunate or dihydroartemis?inin and primaquine or dihydroartemisinin and piperaquine and symptomatic treatment the short?term and long?term cure rates were 98.55%and 94.93%respectively with 1 case unrecovered and 1 died. Conclusions Artemisinins are still the most effective antimalarial drugs for falciparum malaria. However some patients recrudesce as the Plasmodium in their body is resis?tant or insensitive to these drugs. We should pay more attention to the antimalarial and symptomatic treatments in the early stage of severe malaria so as to improve the cure rate.

Objective To compare the clinical efficacy between covered stent and uncovered stent in transjuglar in-trahepatic portosystemic shunt (TIPS) .Methods Thirty patients with liver cirrhosis (portal hypertension), who received TIPS, were retrospectively studied.All patients were divided into two groups covered-stent group(n =20) and uncovered-stent group (n=10).For each patient, portal pressure was measured before and after operation, and the patency of shunt was evaluated by color Doppler ultrasound after operation.The mortality, recurrent bleeding rate and incidence of hepatic encephalopathy were analyzed by Fisher exact probability test.Results The TIPS treatment was successful in all patients, the portal pressure in the covered-stent group reduced from (3.78±0.50) kPa before operation to (2.21±0.44) kPa and that of the uncovered-stent group reduced from (3.67±0.48) kPa to (2.13±0.35) kPa.Twenty-six cases were postoperatively followed-up (17 cases in covered-stent group, 9 cases in uncovered-stent group).The follow-up period varied from 7 days to 62 months (median follow-up period was 23 months).Thirteen patients died of upper gastrointestinal bleeding and hepatic failure.The difference of mortality between covered-stent group (8/17) and uncovered-stent group (5/9) did not reach significant (P>0.05).The recurrent bleeding rate between the covered-stent group (5/17) and the uncovered-stent group (3/9) was not different too (P>0.05).The incidence of hepatic encephalopathy in the covered-stent group (4/17) was not different from that of the uncovered-stent group (2/9) (P> 0.05).The patency rates of 6 months and 12 months reached 100% in the covered-stent group, which were higher than those in the uncovered- stent group 77.8% (7/9) and 55.6% (5/9) (P<0.05) .Conclusions The patency rate of shunt at 12 months after TIPS was higher in the covered-stent group than the uncovered-stent group, while the mortality, recurrent bleeding rate and incidence of hepatic encephalopathy were not significantly different between the two groups.

Objective To evaluate the effectiveness of the treatment of high risk benign prostatic hyperplasia (BPH) with transrectal high-intensity focused ultrasound (TR-HIFU) by urodynamic test. Methods One hundred and thirty patients with BPH, most of who suffering with diabetes mellitus,cardio-cerebrovascular disease, respiratory disease. All patients were given the operation with Sonablate-500 high-intensity focused ultrasound (HIFU). International prostate symptom score (IPSS), quality of life (QOL), maximum urinary flow rate (Qmax), post void residual urine volume (PVR), pressure-flow tests (A-G) were employed for the evaluation of curatives effect on preoperation, 30th and 90th day after the treatment. Results The duration of the TR-HIFU prostate ablation treatment was 15-85 rain. One hundred and seven patients after treatment were followed up for 3 months. Compared the effect before treatment with that after treatment, IPSS improved from (27.0 ±11.5) scores to (8.5±1.4) scores, Qmax increased from (5.7±2.3) ml/s to (14.1±4.2) ml/s, PVR decreased from (118.5±78.0) ml to (30.0±15.0) mI,A-G parameters reduced from 62.4±19.3 to 25.6±13.0 and urine volume (VV) increased from (85.8 + 42.0) ml to (194.0±52.0) ml. The parameters all altered obviously (P < 0.05). Conclusions TR-HIFU appears highly attractive as a new optional, safe and efficacious and minimally invasive treatment for the high risk BPH. Main post-operative urodynamie parameters are more obviously improved than those of the preoperation.

Objective To observe the outcomes of the modified multiple nerve transfer s combined with the late hand function reconstruction to restore the active pick-up function of the paralyzed upper extremity in patients with total brachial plexus avulsion injuries (TBPAI).Methods 33 patients suffered with TBPAI firstly underwent multiple nerve transfers,which including accessory nerve transfers to neurotize the suprascapular nerve to recover the shoulder abduction,contralateral C7 (CC7) nerve transfers via the modified pre-spinal route with direct coaptation to restore lower trunk function and the musculocutaneous nerve was also neurotized by the transferred CC7 nerve via a cutaneous nerve graft to restore the function of elbow flexion,as well as the phrenic nerve transfers to neurotize the posterior division of lower trunk to restore the function of elbow and finger extension.The patients with muscle recovery were selected to perform the hand function reconstruction at the second stage for restoring the active pick-up function.The patients were chosen as followcriterias:the degree of shoulder abduction attained 30°or more,the motor power of elbow,wrist,and finger flexion attained grade M4 or more,elbow and finger extension attained M3 or more.The methods of hand function reconstruction included wrist fusion and flexor carpal ulnaris opponensplasty,in addition to palmar capsulodesis of the metacarpophalangeal joint.Results The mean follow up was 41±7.7 (range,36-73 months) after the first procedure of multiple nerve transfers,the muscle strength of elbow and finger and wrist flexion attained M 4 as well as the elbow and finger extension achieved M3 or more in 10 patients,all of 10 patients achieved 40°-80°shoulder abduction.8 out of 10 patients had performed the second surgical procedure for hand functional reconstruction.6 of them had successfully recovered the active pick-up function.Conclusions The newly designed procedure of multiple nerve transfers could effectively restore the function of shoulder abduction,elbow,wrist,and finger flexion,as well as elbows and finger extension in patients with TBPAI,combined with the hand functional reconstruction,active pick-up function could be successfully reconstructed.