Objective To establish an evaluation index system for the quality and safety of the specialized nursing care in cardiovascular medicine. Methods To screen and evaluate the safety quality evaluation index via a group discussion with Delphi method and analytic hierarchy process referenced to the literatures from the evaluation index of domestic nursing safety quality (NSQ)and on the base ofthe factor quality- quality of links-final quality3-dimensional quality structure theory by Donabedian. Results The first and second round of expert consultation and the recovery rate were 97.05% (33/34) and 94.12% (32/34) respectibely, the effective rate was 100%;The authoritative coefficient of expert of the safety quality evaluation index of the specialized nursing care is 0.867 and 0.879 respectively. In the first round, the average of the importance rating is 3.50-5.00, the standard deviation is 0-0.042 and full mark rate is 34.10%-100%. In the second round, the average of the importance rating is 3.80-4.70, the standard deviation is 0~0.047 and full mark rate is 31.60%-100%. The fluctuation degree of the first round is more than 0.10 with a low coordination degree. However, the fluctuation degree of the second round result is less than 0.10. The coordination coefficients from all qustionnair scores by experts in the two roudns are 0.169 and 0.286. The difference was statistically significant according to the chi-square analysis (X2=6.842, P=0.002). The NSQ evaluatin index included 3 first degree indexes (weight coefficient including 0.2684,link qualing 0.6144,and quality 0.1172),16 second degree indicators (weight coefficient 0.034~0.0859) and 61 third degree indexes ( weight coefficient 0.034~0.0859) and 61 third degree indexes (weight coefficient 0.0052~0.0412). Conclusions This paper preliminary established a specialied NSQ evaluation index with factor quality- quality of links-final quality 3-dimensional quality structure in the field of cardiovascular medicine, which is based on Delphi method and analytic hierarchy process. NSQ provides a measurement tool for nurses in CME.

Mixed reality technology can achieve a 3D reconstruction of the patient's imaging data and organically combine the real scene. This allows to simulate a real medical operation in clinical teaching. Combined with large data analysis, mixed reality technology allows to build situational awareness data models, thus providing data support for teaching interaction and disease simulations. In the present work, the application of mixed reality technology and situational awareness in clinical teaching of cardiac macrovascular surgery is explored innovatively. These technologies open a new avenue for teaching, solving the issue that stymies traditional teaching approaches and improving the teaching efficiency. It is thus important to explore and promote the applications of this innovative teaching methodology particularly in clinical teaching.

Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Doxorubicin ; administration & dosage ; analogs & derivatives ; pharmacology ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; pathology ; Valproic Acid ; administration & dosage ; pharmacology

Objective To explore the clinical efficacy of Baihu decoction combined with insulin on type 2 diabetes with acute hyperglycemia patients.Methods A total of 86 cases of type 2 diabetes with acute hyperglycemia patients were randomly divided into experimental group (n=43) and control group (n=43).Two groups of patients underwent conventional exercise and diet adjustment intervention, control group was treated with insulin, continuous injection of 14d, experimental group was treated with Baihu decoction based on control group, 7d was taken for one courses, two course in all.The clinical symptoms of the two groups were compared, and the FPG, 2hPBG, HbAlc levels was detected in two groups pre-and post-reatment, the serum IL-6, hs-CRP, TNF-α, LP, APN, Cor were detected by enzyme linked immunosorbent assay method.Results The total effective rate was 91.7%in experimental group, higher than 76.7% in control group(P<0.05).After treatment, FPG, 2hPBG, HbAlc, IL-6, hs-CRP, TNF-αlevels in two groups were all significantly decreased (P<0.05), and those indexes in experimental group were significantly lower than those in control group (P<0.05).After treatment, APN and LP were significantly decreased, Cor was significantly increased in two groups(P<0.05), and the LP and APN in experimental group were significantly lower and Cor was significantly higher than that in control group (P<0.05).Conclusion Baihu decoction combine with insulin can significantly improve the clinical symptoms in type 2 diabetes with acute hyperglycemia patients, reduce the level of blood glucose and cytokines, and its mechanism may be relate to the increase APN level, reduce the LP and Cor levels.

China ; Clinical Trials as Topic ; methods ; Humans ; Organizational Policy ; Publishing ; standards ; Registries

60 Candida strains were analyzed with randomly amplified polymorphic DNA(RAPD) from HIV-infected patients' oral cavity.The results showed that RAPD-PCR fingerprinting appeared from zero to five bands whose size rang from 300 bp to 2 kb with P2 primer,Candida albicans have three characteristic bands of 300 bp,400 bp and 600 bp in size,non-Candida albicans have the similar bands.They can be clas-sified five genetic clusters and 14 genotypes by Cluster Analysis,two Candida albicans(P385&P403) with fluorocytosine-resistance were classified into C1 genotype for "Squared Euclidean Distance" being 0.115,one Candida albicans(P321) and one Candida glabrata(P522) who were resistant against Amphotericin B were classified into D1 genotype for "Squared Euclidean Distance" being 0.221.So,an abundant genetic polymorphism appeared in Candida species related HIV,RAPD could be as a reference for genotype of Candida albicans;different Candida speices had some special bands,different Candida strains had similar bands in the same species;it is perhaps that some genotypes were relevant to drug resistance.

Objective To investigate the safety of vaginal delivery in gravidas with previous cesarean section and its influencing factors.Methods Four hundred and seventy-four full-term gravidas who received cesarean section at the Department of Obstetrics and Gynecology of Peking University First Hospital from January 1,2012 to August 31,2014 were enrolled in this study.Among those subjects,38 who underwent successful vaginal delivery were grouped into vaginal birth after cesarean (VBAC) group,and the other 436 accepting repeated cesarean section were grouped into cesarean group.Delivery outcomes and maternal/neonatal complications of the two groups were retrospectively analyzed with two-sample t-test and Chi-square test.Results Among the 45 patients (9.5％) who attempted VBAC,seven underwent cesarean section for suspected fetal distress and the other 38 (84.4％) succeeded in vaginal birth without uterine rupture.The amount of postpartum hemorrhage in patients of cesarean group was more than that of VBAC group [(330.8±94.8) vs (257.7± 199.7) ml,t=2.021,P＜0.01] after exclusion of three patients with dangerous placenta previa,and the postpartum hospital stay was shorter than that of cesarean group [(2.5± 1.4) vs (4.5± 1.3) d,t=7.952,P＜0.01].There were three newborns with neonatal asphyxia,twelve with neonatal infections and forty transferred to the Pediatrics Department following cesarean section.Besides,complications of headache and urinary retention occurred in 20 and 32 mothers after cesarean section,respectively.However,no complication occurred in VBAC group.Sixty-three cesarean sections were indicated as thin lower uterine segment and among them,fourteen (22.2％) had muscular rupture.Among the six patients who complained of tenderness in lower uterine segment,three were found having muscular rupture during cesarean section.Conclusion VBAC is an option for gravidas with history of cesarean section only if they meet the criteria for VBAC attempt.VBAC could lower the cesarean section rate without increase the incidence of complications.The rate of trial of labor after cesarean was low,patients education should be strengthened to increase it.

Objective The risk of ovarian/pelvic serous cancer can be reduced by prophylactic bilateral salpingectomy ( PBS) at the time of hysterectomy .This study was to evaluate the short-term influence of PBS plus hysterectomy on ovarian reserve in premenopausal women . Methods We retrospectively analyzed the clinical data about 60 premenopausal women treated by total lapa-roscopic hysterectomy ( TLH) for benign indications , 30 undergoing PBS at the same time ( the experimental group ) while the other 30 with the ovary preserved ( the control group ) .We compared the levels of FSH, LH, E2, and anti-Müllerian hormone ( AMH) and the inci-dence of peri-menopausal symptoms between the two groups of patients before and at 1 and 3 months after operation . Results Statistically significant differences were not observed between the two groups in the such baseline clinical characteristics as age , gravidity, parity, men-strual cycle, comorbidity, diagnosis, comorbidities, and history of abdominal surgery (P>0.05), nor in the AMH level at the baseline ([1.08±0.08] vs [1.04±0.10] ng/mL) or at 1 month ([0.86± 0.44] vs [0.81±0.48] ng/mL) or 3 months postoperatively ([0.84±0.94] vs [0.68±0.42] ng/mL) (F=0.247, P=0.746).Howev-er, the mean level of AMH was markedly reduced at 1 and 3 months after operation as compared with the baseline ( P<0.05) , though with no significant difference between 1 and 3 months ( P>0.05) .There were not any statistically significant differences in the levels FSH, LH, and E2 between the two groups before or at 1 and 3 months after surgery (P>0.05), nor in the incidence rates of peri-menopausal symptoms at 1 month (6.7%vs 3.3%, P>0.05) or 3 months postoperatively (10.0%vs 6.7%, P>0.05). Conclusion PBS at the time of total hysterectomy in premenopausal women does not affect ovarian reserve in the short term .The level of AMH has a higher sensitivity than those of FSH , LH and E2 in the assessment of postoperative ovarian function .

microRNAs combined with specific mRNAs are 19-25 nucleotide-long small-molecule RNA that mediate sequence-dependent post-transcriptional gene expression.Accumulating evidences indicate that microRNAs target critical signal transduction molecules of immune system,and involve in regulation of immune tolerance.Recently,microRNAs have been a potential biomarker,and are widely useded in diagnosis and prognosis of cancer,infectious disease,autoimmune disease,and transplantation.If we can further identify regulatory mechanism of microRNAs and their target genes,which makes possible the successful induction of immune tolerance and exert a huge push on organ transplantation.

Objective To investigate the situation of pre-pregnancy health check in rural areas of Sichuan province and get the key difficult points during the process of carrying out the work.Methods According to the economic situation in Sichuan province and geographic distribution,random eight areas in Sichuan province (Chengdu,Neijiang,Nanchong,Ziyang,Meishan,Zigong,Les-han and Suining),investigate pregnant women in maternal and child health care institutions and family planning service institutions at all all levels in the areas above.Results Only 334 people (33.26%)underwent the pre-pregnancy health check during the 974 pregnant women in rural areas.The rate of planned pregnancy is low;the rate of unintended pregnancy is close to 40.00%.55.29%of the planned pregnancy women didn′t undergo the pre-pregnancy health check.And the factors that affect their behavior of under-going pre-pregnancy health check are whether planned pregnancy and personal attitude towards pre-pregnancy health check.Conclu-sion The rate of pre-pregnancy health check is low in the pregnant women from rural areas of Sichuan province,the health sector needs to make efforts to promote and enhance the awareness of the rural pregnant women to prevent birth defects and the initiative in participation.