The clinical handover, which is associated with the observation of the changes in patients′ status and the implementation of nursing process, plays a vital role in critical care. Also, the quality of clinical hand-over has a far-reaching impact on patient safety due to the complicate condition of critical patients. Over the past few years, lots of studies have focused on the many aspects of clinical handover such as the contents of clinical handover, the standard procedure of clinical handover so as to reduce the risks associated with the unsystematic clinical handover.

Purpose To investigate the diagnostic value of p16/Ki-67 dual stain cytology for detection of cervical precancerous lesions as a novel option for cervical lesions screening.Methods A total of 295 cases diagnosed as atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL) from thinprep cytologic test (TCT) were selected.Double staining of p16/Ki-67 cytology,vaginal biopsy,biopsy and pathological examination were applicated,p16/Ki-67 dual stain cytology was compared with that of biopsy and pathological examination.At the same time,The sensitivity and specificity of p16/Ki-67 dual stain cytology between ASC-US and LSIL was analyzed.Results The positive rate of p16/Ki-67 dual stain cytology were 37.42％ and 36.36％ in ASC-US and LSIL,respectively.The positive rate of cervical intraepithelial neoplasia 2/3 (CIN2/3) were 25.77％ and 25.76％.The sensitivity and specificity of the p16/Ki-67 test for detecting CIN2/3 was 83.33％ and 78.51％.The sensitivity and the specificity of the p16/Ki-67 test for detecting CIN2/3 was 85.30％ and 80.61％ in LSIL group.Conclusion p16/Ki-67 double stain cytology detection can improve the sensitivity of CIN2/3 and the specificity of human papilloma virus (HPV).p16/Ki-67 double stain detection can effectively triage the high grade cervical lesions in TCT and improve the accuracy of cervical cancer screening.

Objective To assess the effectiveness of uterine arterial embolization for the treatment of hysteromyomas and to discuss the factors related to the clinical results.Methods Super-selective uterine arterial embolization was performed in forty-five patients with hysteromyomas.Of 45 patients,multiple hysteromyomas were seen in 36 and solitary lesion in 9.The lesion was located at the myometrium in 41 cases,among them coexisted endometrioma was found in 5 cases and coexisted submucosal myoma in 2.The lesion was located submucous layer in the remaining 4 cases.The diagnosis was confirmed by imaging study and gynecological examination.After the operation,ultrasonography and laboratory tests were carried out in all patients to observe the tumor size.hormone levels and hemoglobin concentration.Results A total of 91 uterine arteries were found in 45 patients.including double left uterine arteries in one case.Successful catheterization was obtained in 87 arteries(95.6%).All forty-five patients were followed up for 6-36 months.Six months after the procedure the mean reduction of the tumor size was 69.3%.and the lesion completely disappeared in two cases.In the anemic patients the hemoglobin concentration returned to normal level.The main side-effects included low fever and pain at lower abdomen.Conclusion Uterine arterial embolization is a safe and effective treatment for hysteromyomas.

Objective To evaluate the efficacy of different doses of dexmedetomidine for prevention of shivering after combined spinal-epidural anesthesia in the patients undergoing caesarean section.Methods A total of 120 patients,of ASA physical status Ⅱ or Ⅱ,aged 20-40 yr,with body mass index≤ 35 kg/m2,scheduled for elective caesarean section under combined spinal-epidural anesthesia,were randomly divided into 4 groups (n =30 each) using a random number table:control group (group C) and dexmedetomidine 0.1,0.3 and 0.5 μg/kg groups (D1,D2 and D3 groups).Combined spinal-epidural anesthesia was performed at L3,4 interspace with isobaric 0.5％ bupivacaine 2 ml.In D1,D2 and D3 groups,dexmedetomidine 0.1,0.3 and 0.5 μg/kg (in 50 ml of normal saline) were infused intravenously,respectively.In group C,normal saline 50 ml was infused at a rate of 5 ml/min.The development of shivering,bradycardia,hypotension,nausea and vomiting was recorded during the period from the end of dexmedetomidine infusion to PACU discharge time.Results Compared with group C,the incidence and degree of shivering and incidence of nausea and vomiting were significantly decreased in D2 and D3 groups,and no significant change was found in the parameters mentioned above in group D1.Compared with group D2,the incidence and degree of shivering and incidence of nausea and vomiting were significantly decreased in D3 group.Conclusion Dexmedetomidine 0.3 and 0.5 μg/kg can prevent shivering after combined spinal-epidural anesthesia in the patients undergoing caesarean section,and 0.5 μg/kg provides better efficacy.

Objective To evaluate the efficacy of follicular unit extraction (FUE) in the repair of scarring eyebrow loss.Methods A total of 30 patients with scarring eyebrow loss were treated with FUE technique in the Department of Plastic Surgery of Zhengzhou First People's Hospital,including 18 females and 12 males with 41 eyebrow defects.Fine soft hairs with a length of 5-10 mm were extracted from the back of the ear and temporal region of the patients,and then were split into individual follicular units under a microscope at 6 × magnification.The transplant density ranged from 20 to 30 FU/cm2.Results During the 3-18 months of follow-up after the surgery,eyebrows in the recipient areas grew in a natural direction and showed good appearance.The survival rate of hair grafts was up to 90％,and the patients were satisfied with the results.Conclusion FUE may be an ideal method for the treatment of scarring eyebrow loss with less injury and high survival rate of hair grafts.

OBJECTIVETo investigate the therapeutic effect of soft tissue expansion combined with follicular unit extraction( FUE) for burn cicatricial bald.

METHODS48 patients with burn cicatricial bald (> 25 cm2) were treated in three stages. The expanders were implanted on the first stage. After expansion for 8 weeks, the expanders were taken out and local flaps were transferred. One year later, follicular unit extraction( FUE) was applied on the bald area.

RESULTS48 cases were followed up for 5 years with satisfactory cosmetic results. The VAS assessment of satisfaction on hair appearance after three-staged surgery was 8.2 ± 2.1.

CONCLUSIONSSoft tissue expansion combined with FUE has a reliable effect for burn cicatricial bald.

Alopecia ; etiology ; surgery ; Burns ; complications ; surgery ; Female ; Hair ; transplantation ; Hair Follicle ; transplantation ; Humans ; Male ; Surgical Flaps ; transplantation ; Tissue Expansion ; methods ; Tissue Expansion Devices

[Summary] The neuropeptides orexin A and orexin B are involved in numerous central regulation processes such as energy homeostasis,sleeping behaviour,and neuroendocrine activities.Orexin receptors are expressed in a variety of tissues besides the brain,adrenal gland for example.The article reviews the effect of orexin on adrenal gland function.

OBJECTIVETo establish a method for detecting plasma concentration of corn polysaccharide iron complex (CPIC) and investigate its absorption, distribution and elimination in rats.

METHODSUsing radioactivity isotope tracing method, we detected the radioactivity of (59)Fe-CPIC in the plasma of rats at different time points by gavages of 3 doses (28.0, 14.0, and 7.0 mg/kg) (59)Fe-CPIC in SD rats. The pharmacokinetic parameters was obtained using DAS 2.0 program for analysis of tissue distribution and elimination of (59)Fe-CPIC.

RESULTSThe standard curve was linear within the range of 0.14-141 µg/ml (r=0.9999, n=5). The average recovery was 95% with a relative standard deviation no more than 15%. The pharmacokinetic parameters at 3 doses obtained, namely t1/2 and AUC (0-), were 214∓104, 231∓110, and 181∓81 min, and 1986.3∓513.3, 737.0∓467.0, and 315.1∓226.1 mg·min-1·L(-)1, respectively. (59)Fe-CPIC were detected in all the 13 tissues types examined and high radioactivity intensity was found in the gastrointestinal tract, hematogenic organs and other organs rich in blood. (59)Fe-CPIC was eliminated after intragastric administration primarily via the feces in rats.

CONCLUSIONThe method we established is easy and specific, and the pharmacokinetic parameters of (59)Fe-CPIC fit the two- compartment open model.

Administration, Oral ; Animals ; Area Under Curve ; Coordination Complexes ; administration & dosage ; pharmacokinetics ; urine ; Feces ; chemistry ; Female ; Intestinal Absorption ; Iron ; administration & dosage ; pharmacokinetics ; urine ; Iron Radioisotopes ; Male ; Polysaccharides ; administration & dosage ; isolation & purification ; pharmacokinetics ; urine ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tissue Distribution ; Zea mays ; chemistry

can specifically combined with EGFR, which may be applied to noninvasive NIRF imaging of tumors highly expressed EGFR in vivo.

Objective:To investigate the risk factors associated with failure of trial of labor in primiparous women with preeclampsia (PE) and to establish a risk prediction model.Methods:Primiparae with PE who underwent trial of labor in the Department of Obstetrics of Suzhou Ninth People's Hospital from February 2018 to July 2020 were retrospectively selected as the modeling set, and divided into two groups: the success group and the failure group. Various parameters were compared between the two groups and those data with statistically significant difference were analyzed with multivariate logistic regression analysis. Those factors related to vaginal delivery failure in primiparous women with PE were identified. Based on the results, a risk prediction model was established using R language. Its performance was assessed with receiver operating characteristic (ROC) curve and goodness-of-fit test. This study also retrospectively enrolled primiparae with PE who underwent trial of labor in the same hospital from August 2020 to December 2021 as the validation set. Bootstrap method was used for verification and a calibration chart was created.Results:A total of 312 PE patients were selected as the modeling set with 89 in the failure group and 223 in the success group. Another 146 primiparae with PE were selected as the validation set. Logistic regression analysis showed that older age ( OR=1.609, 95% CI: 1.251-2.483), higher body fat rate in early pregnancy ( OR=1.456, 95% CI: 1.209-2.159) and higher ratio of umbilical artery systolic to diastolic flow velocity within a week before delivery ( OR=1.799, 95% CI: 1.372-2.794) were risk factors for vaginal delivery failure in primiparae with PE, while more maternal education during pregnancy ( OR=0.233, 95% CI: 0.054-0.672) and higher Bishop score ( OR=0.395, 95% CI: 0.258-0.756) were protective factors. A nomogram model to predict the risks of vaginal delivery failure was constructed based on the above five factors. The area under the ROC curve (AUC) of the modeling set was 0.921 (95% CI: 0.847-0.963) with the cut-off value of 0.213, and the corresponding sensitivity and specificity were 0.871 and 0.852, respectively;goodness-of-fit test showed that the observed values matched with those expected ( χ2=7.69, P=0.464); and the calibration curve indicated that the consistency of the prediction model was good. The AUC of the validation set was 0.903 (95% CI: 0.835-0.942) with the sensitivity and specificity of 0.892 and 0.796, respectively; the discrepancy between the observed values and those expected was not significant as indicated by goodness-of-fit test ( χ2=6.82, P=0.512); calibration curve of the validation set showed that the predicted values of the model was consistent with the actual values. Conclusions:The failure of vaginal delivery in primiparae with PE is associated with maternal age, prenatal body fat percentage, ratio of fetal umbilical artery systolic to diastolic flow velocity within a week before delivery, maternal education during pregnancy and Bishop score. The nomogram model based on these five risk factors for prediction of vaginal delivery failure performs well.