Objective To explore the causes of medical safety adverse events in our hospital in order to improve the hospital's medical safety and quality. Methods The medical safety adverse events occurred in our hospital from 2013 to 2014 were retrospectively analyzed, focusing on the analysis of the department, type and severity of adverse events. Results Medical safety adverse events mainly occurred in surgery. The main types of medical safety incidents were drug incidents, and the severity was mostly reported by Class Ⅱ incidents (adverse event events). Conclusion By analyzing the causes of adverse medical safety incidents, relevant medical safety management measures are formulated to timely contain medical safety adverse events.

OBJECTIVETo evaluate the efficacy and necessity of retained rectal posterior mucosa in procedure for prolapse and hemorrhoids (PPH).

METHODSClinical data of 260 cases with severe hemorrhoids in our hospital from January 2010 to May 2012 were analyzed retrospectively. A total of 132 cases with severe hemorrhoids excluding in rectal posterior wall were enrolled in retained rectal posterior mucosa in PPH (improvement group), other 128 cases of severe hemorrhoids were assigned to PPH (conventional group). Operative parameters, efficacy and complication after operation were compared.

RESULTSTwo groups of patients received successful operations. Postoperative pain duration, frequency of analgesic drugs and postoperative hospital stay in improvement group were significantly reduced [(1.3 ± 0.5) d vs. (4.8 ± 0.7) d, 1.1 ± 0.3 vs. 5.9 ± 0.6, (5.2 ± 0.8) d vs. (5.8 ± 0.5) d, all P<0.01]. Incidence of anastomotic stenosis, heavy feeling in the anus and delayed bleeding in improvement group were significantly lower than those in conventional group (0 vs. 7.8%, 0.8% vs. 14.1%, 0 vs.7.8%, all P<0.01).

CONCLUSIONSThe application of retained rectal posterior mucosa in PPH to patients with severe hemorrhoids excluding in rectal posterior wall can significantly reduce postoperative complications. But long-term efficacy needs further observation.

Constriction, Pathologic ; Hemorrhoids ; epidemiology ; surgery ; Humans ; Incidence ; Mucous Membrane ; Pain, Postoperative ; Postoperative Complications ; Postoperative Period ; Prolapse ; Retrospective Studies

Objective To evaluate the efficacy and necessity of retained rectal posterior mucosa in procedure for prolapse and hemorrhoids (PPH). Methods Clinical data of 260 cases with severe hemorrhoids in our hospital from January 2010 to May 2012 were analyzed retrospectively. A total of 132 cases with severe hemorrhoids excluding in rectal posterior wall were enrolled in retained rectal posterior mucosa in PPH (improvement group), other 128 cases of severe hemorrhoids were assigned to PPH (conventional group). Operative parameters, efficacy and complication after operation were compared. Results Two groups of patients received successful operations. Postoperative pain duration , frequency of analgesic drugs and postoperative hospital stay in improvement group were significantly reduced [(1.3±0.5) d vs. (4.8±0.7) d, 1.1±0.3 vs. 5.9±0.6, (5.2±0.8) d vs. (5.8±0.5) d, all P<0.01]. Incidence of anastomotic stenosis, heavy feeling in the anus and delayed bleeding in improvement group were significantly lower than those in conventional group (0 vs. 7.8%, 0.8% vs. 14.1%, 0 vs.7.8%, all P<0.01). Conclusions The application of retained rectal posterior mucosa in PPH to patients with severe hemorrhoids excluding in rectal posterior wall can significantly reduce postoperative complications. But long-term efficacy needs further observation.

Objective To evaluate the efficacy and necessity of retained rectal posterior mucosa in procedure for prolapse and hemorrhoids (PPH). Methods Clinical data of 260 cases with severe hemorrhoids in our hospital from January 2010 to May 2012 were analyzed retrospectively. A total of 132 cases with severe hemorrhoids excluding in rectal posterior wall were enrolled in retained rectal posterior mucosa in PPH (improvement group), other 128 cases of severe hemorrhoids were assigned to PPH (conventional group). Operative parameters, efficacy and complication after operation were compared. Results Two groups of patients received successful operations. Postoperative pain duration , frequency of analgesic drugs and postoperative hospital stay in improvement group were significantly reduced [(1.3±0.5) d vs. (4.8±0.7) d, 1.1±0.3 vs. 5.9±0.6, (5.2±0.8) d vs. (5.8±0.5) d, all P<0.01]. Incidence of anastomotic stenosis, heavy feeling in the anus and delayed bleeding in improvement group were significantly lower than those in conventional group (0 vs. 7.8%, 0.8% vs. 14.1%, 0 vs.7.8%, all P<0.01). Conclusions The application of retained rectal posterior mucosa in PPH to patients with severe hemorrhoids excluding in rectal posterior wall can significantly reduce postoperative complications. But long-term efficacy needs further observation.

Objective To investigate the prevalence of hyperuricemia (HUA) in the elderly in Tanggu Community of Tianjin,and to analyze the related factors.Methods The elderly inhabitants from one community of Tanggu in Tianjin were randomly selected and their serum uric acid (SUA)levels and metabolic syndrome (MS)-related indexes were examined.There were 622 subjects with complete data (260 men,362 women; mean age 67.4 ± 6.0 years).Results The standardized prevalence of HUA in the elderly in this community was 9.1％ in total,and 7.6％ in males,10.6％ in females,and there was no significant difference between males and females (P=0.281).The levels of SUA were (283.37 ± 78.69) μmol/L in total,(315.80 ± 74.39) μmol/L in males and (260.00 ±73.31) μmol/L in females,and the SUA level was higher in males than in females (P＜0.001).The levels of blood urea,creatinine (Cr),triglyceride (TG),body mass index (BMI) were higher in patients with HUA than in patients with normal serum uric acid (P=0.000,0.000,0.002,0.049respectively).The multiple factors regression analysis showed that the SUA level was positively correlated with the levels of blood urea,Cr,TG,low density lipoprotein cholesterol (LDL-C) (P=0.000,0.017,0.000,0.019) and was negatively correlated with the levels of high density lipoprotein cholesterol (HDL-C) and fasting blood glucose (P=0.000,0.001).Conclusions The prevalence of HUA in the elderly is lower in Tanggu Community of Tianjin than in other cities in China.The SUA level of the elderly is significant higher in males than in females.The lower kidney function,hypertriglyceridemia and higher LDL-C are the risk factors for HUA,while elevated HDL-C and fasting blood glucose are associated with the decreased SUA level.

Objective To investigate the prevalence of metabolic syndrome (MS) and its components among the elderly at Tanggu community in Tainjin. Methods The elderly inhabitants were drawn out randomly from one community at Tanggu in Tianjin to examine the MS-related indexes. There were 623 samples with complete data aged (67.4±6.0) years, including 261 males with mean age of (68.3±6.1) years and 362 females with mean age of (66.9±6.0) years. Diagnosis of MS was done by criteria of Chinese Medical Association Diabetes Branch in 2004. Results The standardized prevalence of MS for the elderly in the community was 18.5% with the highest risk group aged 60～69 years. Standardized prevalences of hypertension, high triglycerides, high blood sugar, overweight, obesity, low HDL-C were 49.5%, 38.8%, 25.3%, 42.0%, 4.2%, 3.0% in the elderly. Conclusions The prevalence of MS in the elderly is lower in Tanggu community in Tianjin than in Shanghai, Foshan in Guangdong, Qingdao in Shandong and Beijing city. The condition in female is more severe than in male, the highest prevalence occurs in hypertension, and overweight, high triglycerides and high blood sugar follow it, but few of them are obesity, low HDL-C is fewer too.

Objective To evaluate the value of L-(methyl-11C)-labeled methionine positron emissions tomography (MET PET) and MRI in target volume delineation for postoperative radiotherapy for brain high grade glioma (HGG).Methods Thirty-seven patients with supratentorial HGG were included.Both MRI and MET PET scan were performed in the same treatment position for all patients.The consistency to determine residual tumor between MRI and MET PET was analyzed.Imaging data of MET PET and MRI were coregistered using the BrainLAB image fusion software.The extension of the volume with high uptake (VMET) on MET PET were compared quantitately with the enhancing area on MRI T1W gadolinium enhancement (VGd) and the hyperintensity area on MRI T2W (VT2).Results Both MET PET and MRI were positive for 19 patients and negative for 7 patients.The consistency between these two scans was 70.3%.MET PET was integrated with MRI in 30 patients with positive MET uptake.VMET were partially or entirely outside VGd in 29 patients and VT2 in 17 patients, whereas VGd and VT2 were partially or entirely outside VMET in all patients.The maximal distance from the margin of VMET to VGd was ≥ 2.0 cm in 50%patients and the corresponding distance of VMET to VT2 was ≥ 1.0 cm in 33% patients.Conclusions The differences are existing between MET PET and MRI in determination and identification of the location and extension of residual tumor for patients with HGG.The integration of MET PET and MRI can accurately delineate radiation target volume.

Objective To study the abnormalities of noninvasive urodynamios in early diabetes eystopathy (DCP) and provide diagnosis evidences in its early stage. Methods According to the disease course (less or more than 1 year), 85 patients with type 2 diabetes mellitus (T2DM) were divided into new lydiagnosed diabetic group and non-newly diagnosed diabetic group. Thirty healthy cases were involved in normal control group. All of them were checked with the technology of noninvasive urodynamics to measure maximal flow rate, average flow rate, the volume leading to first bladder sensation and residual urine volume. Results As to the 32 newly diagnosed diabetic group, maximal flow rate was (18.4±6.9) ml/s, and average flow rate was (10.6 ± 5.3) ml/s, 18 cases were detected to have bladder residual urine, with the average residual urine volume of (13.2 ± 17.3) ml, and the DCP detection rate was 56.2%(18/32). As to the 53 non-newly diagnosed diabetic group, maximal flow rate was (14.7 ± 6.6) ml/s, and average flow rate was (9.5±4.7) ml/s,38 cases were detected to have bladder residual urine, with the average residual urine volume of (19.3 ± 18.4) ml, and the DCP detection rate was 71.7%(38/53). There was no residual urine detected in normal control group. Their maximal flow rate was (25.7 ± 5.9) ml/s, and average flow rate was (18.0 ± 4.9)ml/s. Compared with that in normal control group, maximal flow rate, average flow rote and residual urine volume decreased in both newly diagnosed diabetic group and non-newly diagnosed diabetic group(P< 0.01). As compared with that in newly diagnosed diabetic group, maximal flow rate in non-newly diagnosed diabetic group decreased obviously (P< 0.05). Conclusions The abnormalities of urodynamics may happen in the early stage of diabetes, and maximal flow rate may be as the most sensitive index. With the new technology of noninvasive urodynamies, we DCP can be diagnosed in early stage and evaluated the function of bladder dynamically.

Objective To evaluate the early detection of diabetic cystopathy(DCP)with the technology of noninvasive urodynamics.Methods 70 patients with type 2 diabetes mellitus(DM)and 30 normal control subjects were checked with the technology of noninvasive urodynamics.Based on their disease course of less or mole than 5 years.the DM patients were divided into two groups.Maximal flow rate,average flow rate,the volume leading to first bladder sensation and residual urine volume were measured by using noninvasive urodynamic technology.Results Among the 70 DM patients,34 were detected to have bladder residual urine,so the DCP detection rate was 48.6%.In the patients with DCP,the average residual urine volume Was 7-139 ml(30.1±27.1)ml,while there was no residual urine in the normal control group.As compared with the normal control group,maximal flow rate and average flow rate were decreased in all the patients with DM and those with DCP(P＜0.01).After follow up of the disease,the patients with a course of more than five years of disease control had even lower maximal flow rate and average flow rate.Conclusion Maximal flow rate decrease and bladder residual urine detected with the technology of noninvasive urodynamics may be widely used in early detection and early diagnosis of DCP.