Objective:To formulate the maintenance and management process of extracorporeal membrane oxygenation (ECMO) equipment for adults and explore its implementation effect, in order to provide reference for clinical nursing.Methods:A historical control study design was used. A total of 60 patients who received ECMO treatment at the Department of Critical Care Medicine of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, were selected by convenience sampling method as the research subjects. Among them, 30 patients from January to December 2022 were the control group, and 30 patients from 1 to 12 of 2023 were the observation group. The control group received ECMO treatment using routine methods, while the observation group received ECMO treatment according to the maintenance and management process for adult ECMO equipment. The charging time of the ECMO battery, the completeness of the ECMO equipment, the occurrence rate of ECMO equipment failure, the cleanliness rate of the ECMO equipment surface, and the pre-filling time of the ECMO pipeline were compared between the two groups.Results:The control group included 19 males and 11 females, with an age of (51.34 ± 6.85) years. The observation group comprised 21 males and 9 females, with an age of (50.97 ± 5.39) years. In the observation group, the compliance rate of the ECMO battery standby time was observed to be 100.00% (30/30), while the completeness rate of the equipment ready for use was 96.67% (29/30), and the qualification rate of surface cleanliness of ECMO equipment was 93.33% (28/30), all were superior to 76.67% (23/30), 73.33% (22/30), and 63.33% (19/30) in the control group, and the differences were statistically significant ( χ2 = 5.82, 4.71, 7.95, all P<0.05). The incidence rate of ECMO equipment failure in the observation group was 3.33% (1/30), a rate lower than the control group′s 16.67% (5/30), and the difference was statistically significant ( χ2 = 83.18, P<0.001). The pre-filling time of ECMO circuit in the observation group was (9.56 ± 2.20) min, which was less than the control group′s (13.30 ± 2.76) min, and the difference was statistically significant ( t = 5.79, P<0.001). Conclusions:The formulation and implementation of the process help to improve the standardized operation of ECMO in medical care, so that the ECMO equipment and instruments can be well maintained.

Objective:To formulate the maintenance and management process of extracorporeal membrane oxygenation (ECMO) equipment for adults and explore its implementation effect, in order to provide reference for clinical nursing.Methods:A historical control study design was used. A total of 60 patients who received ECMO treatment at the Department of Critical Care Medicine of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, were selected by convenience sampling method as the research subjects. Among them, 30 patients from January to December 2022 were the control group, and 30 patients from 1 to 12 of 2023 were the observation group. The control group received ECMO treatment using routine methods, while the observation group received ECMO treatment according to the maintenance and management process for adult ECMO equipment. The charging time of the ECMO battery, the completeness of the ECMO equipment, the occurrence rate of ECMO equipment failure, the cleanliness rate of the ECMO equipment surface, and the pre-filling time of the ECMO pipeline were compared between the two groups.Results:The control group included 19 males and 11 females, with an age of (51.34 ± 6.85) years. The observation group comprised 21 males and 9 females, with an age of (50.97 ± 5.39) years. In the observation group, the compliance rate of the ECMO battery standby time was observed to be 100.00% (30/30), while the completeness rate of the equipment ready for use was 96.67% (29/30), and the qualification rate of surface cleanliness of ECMO equipment was 93.33% (28/30), all were superior to 76.67% (23/30), 73.33% (22/30), and 63.33% (19/30) in the control group, and the differences were statistically significant ( χ2 = 5.82, 4.71, 7.95, all P<0.05). The incidence rate of ECMO equipment failure in the observation group was 3.33% (1/30), a rate lower than the control group′s 16.67% (5/30), and the difference was statistically significant ( χ2 = 83.18, P<0.001). The pre-filling time of ECMO circuit in the observation group was (9.56 ± 2.20) min, which was less than the control group′s (13.30 ± 2.76) min, and the difference was statistically significant ( t = 5.79, P<0.001). Conclusions:The formulation and implementation of the process help to improve the standardized operation of ECMO in medical care, so that the ECMO equipment and instruments can be well maintained.

Objective This study proposes to visually review the current situation and progress of standards sets by the International Organization for Standardization/Technical Committee on Traditional Chinese Medicine (ISO/TC 249). The review aims to explore the development strategies of the standards, which will exhibit the considerable impact on the economy, trade and exchanges, and cooperation in the area of traditional Chinese medicine (TCM). Methods ISO/TC 249 standards were searched on the ISO website, and their title, proposed time, current stage, scope, and classification were obtained for further summarization. Gephi was utilized to portray the co-occurrence network graph of the ISO/TC 249 standards subject. Results In ISO/TC 249, there were 116 standards, including 81 published standards and 35 developing standards by April 30, 2022. Two withdrawal standards were published after revision, which were not counted in the total standards. The number of published standards has been increasing since the first standard was published in 2014, whose title was “Sterile acupuncture needles for single use”. Among these standards, 17.24% (20/116) standards were in review, 56.03% (65/116) in publication, 3.45% (4/116) in approval, 5.17% (6/116) in enquiry, 3.45% (4/116) in committee, and 14.66% (17/116) in preparation, respectively. With 116 standards, most of the research focused on the medicament, as its classification of the International Classification for Standards (ICS) showed the proportion reaching 49.54%. The network analysis data revealed that the top five most frequent words were “materials” “root” “requirements” “products” and “system”, after removing the noise data, such as prepositions, conjunctions, and pronouns. Additionally, the word “system” co-exists with the terms “computerized” “coding” “image” “tongue” and “analysis”; the word “requirement” co-exists with “manufacturing” “decoction” “process” and “materials”; whereas the word “devices” co-exists with “pulse” “electric” “skin” and “measurement”. Conclusion With the increased diversification and complexity of problems, the development of standards is also oriented to multidisciplinary fields to cultivate the interdisciplinary talents, and especially the international standardization talents of compound TCM. Multi-angle analysis, formulation, and demonstration of standards, in line with industry needs in different disciplines, enhance the availability of standards and the ability to serve the industry.

Objective To evaluated the HCV genotyping results which obtained by genotype diagnostic kit in Shenzhen area. Methods 158 samples which ELISA test of anti-HCV were positive were collected from voluntary blood donors from 2014 to 2015,and were tested by PCR fluorescence probe method for viral load.The samples which viral load were greater than 1.0 ×103 IU/mL were then tested by HCV RNA genotype diagnostic kit.To analysis the proportion of different genotypes and the correla-tion between genotypes with vrial load.Results 54 HCV RNA reactive sample were quantity by PCR fluorescence probe method from 158 anti-HCV positive samples.The genotyping data for 45 cases which vrial load greater than 1.0×103 IU/mL were obtained by HCV RNA genotype diagnostic kit.The frequencies HCV genotype 1b,2,3 and 6 were 57.78%(26/45),6.67%(3/45),8.89%(4/45)and 26.67%(12/45),respectively.One-way ANOVA analysis showed that significant difference in viral loads was found be-tween different HCV genotype 1b and 2(F =2.861,P <0.05),and there was a significant difference in viral loads and anti-HCV S/CO by sex(P <0.05).Fisher′s exact test showed the significance difference between age and genotypes(P <0.05 ).Conclusion HCV 1b and 6 were the most predominant genotypes due to the higher viral load than the other subtypes among volunteer blood do-nors in Shenzhen,while the proportion of HCV 2,3 declined.

Objective To detect the reactive samples of enzyme-linked immunosorbent assay (ELISA1) by chemiluminescence microparticle immunoassay (CMIA),and to analyze the application value of CMIA in HCV infection validation of blood donors.Methods Nucleic acid 3-item combined testing (NAT),another ELISA2,HCV antibody supplementary test(Western Blot test,WB) and CMIA test supplemented in blood samples of 102 ELISA1 anti-HCV reactive blood donors were retrospectively analysed.Results Among 102 blood donors of anti-HCV positive,32 cases (31.37%,32/102) were HCV RNA reactive samples,50 cases (49.02%,50/102) were ELISA2/WB reactive simultaneously.With CMIA NAT results as the reference standard,CMIA was poorly correlated with HCV RNA (Spearman correlation coefficient rs=0.395,P<0.01),and the consistency between them was weak by Kappa test (Kappa=0.270,P<0.01).With ELISA2/WB detection results as the reference standard,CMIA was highly correlated with the results(Spearman correlation coefficient rs=0.713,P<0.01),and which showed high consistency by Kappa test (Kappa=0.674,P<0.01).Conclusion CMIA as a detection method of protein label after HCV infection has great value in the HCV infection confirmation in low-risk population.

Objective Because of high incidence rate of complicated postoperative abdominal infections in abdominal injuries and difficulty in their clinical diagnosis and treatment,this article aimed to investigate the mechanism and the surgical tactics for this kind of complication.Methods Totally 48 abdominal-injured cases of postoperative complicated abdominal infections in our hospital from July 2005 to December 2010 were reviewed.These patients (Male 30,Female 18) aged 16-70 (mean 38) years.There were 20 cases of simple abdominal injuries,and 28 cases of multiple injuries ( ISS 16 - 52,mean 24.42).The complicated postoperative abdominal infections included abdominal incision infections (25cases),intra-abdominal infections( 18 cases) and retroperitoneal infections(5 cases).Forty cases were transferrted from other hospitals to our hospital 2 - 76 days after trauma.16 of which underwent exploratory laparotomy at other hospitals after injury,and 8 cases were directly transferred to our hospital after injury.Results All patients finally had a definite diagnosis by abdominal checking(26 cases),paracentesis(5 cases),ultrasound and CT scan ( 12 cases),and PET/CT scan (5 cases)in our hospital,and were confirmed by cultiure of pathogenic bacteria.The treatment included vacuum sealing drainage (VSD) (25 cases),percutaneous imaging- guided abdominal abscess drainage(13cases) and re-laparotomy ( 10 cases).Successfull treatment was achieved in 46 patients,death in 2 patients.The causes of death consisted of 1 case of severe craniocerebral injury,1 case of MODS.Conclusions Complicated abdominal infections often occurs after the operations of abdominal injuries.attentively abdominal checking,paracentesis,and CT scan repeatedly were proofs to benefit the finally diagnosis.VSD therapy is a simple and effective method for abdominal incision complication,and dynamic CT scan and prompt exploratory laparotomy can improve patients' prognosis.

Objeetlve To evaluate the role of IL-1β and TNF-α in the spinal cord in a murine model of bone cancer pain(BCP)induced by activation of glial cells.Methods Three hundred and sixty male 8-10 weeks old C3H/He mice weighing 18-22 g were randomly divided into 6 groups(n=60 each):group I nomal control (group N);group Ⅱ sham operation (group S);group Ⅲ BCP+aCSF(group aCSF);group Ⅳ BCP+FC (group FC);group V BCP+MI(group MI) and group Ⅵ BCP+FC+MI (group FC-MI).BCP was produced by inieeting fibrosarcoma cells of bone into the medullary cavity of left ealcaneus bone.Intrathecal catheter was placed in the 4 BCP groups(group Ⅲ-Ⅳ).FC 0.5 nmol/5 μl or/and MI 16 μg/5 μl were injected IT once a day for 21 consecutive days after operation.The mechanical threshold to von Frey filaments was measured at 0.5 h(T0)before injection of fibrosarcoma cells and at 3,5,7,10,14,21 d(T1-6)after injection of fibrosarcoma cells.Twelve animals of each group were killed and L4.5 segment of the spinal cord was removed at T0,1,3,5,6 for determination of IL-1β and TNF-α content (by ELISA) and expression (by immuno-flurorescence) in the spinal cord. Results The mechanical threshold was significantly decreased at T1-6, while IL-1β content at T1,3,5,6 and TNF-α content at T5,6 was significantly increased in group BCP, FC, MI and FC + MI compared with those at T0 and group C (P < 0.05). Compared with group BCP, the mechanical threshold was significantly increased at T1-6 in group MI and FC + MI and at T4-6 in group FC, IL-1β content was significantly decreased at Ts,3,5,6 in group MI and FC + MI and at T5,6 in group FC and TNF-α content was significantly decreased at T5,6 in group FC, MI and FC + MI ( P < 0.05). Conclusion IL-1β and TNF-α in the spinal cord is involved in the process of glial cell activation-induced BCP.

Objective To explore the effects and significance of first-aid fast track in the treatment of severe trauma. Methods A retrospective study was done on 60 trauma patients (fast track group)treated by means of first-aid fast track from January 2006 to November 2007 to observe the effect of first-aid fast track. Another 46 trauma patients treated from January 2004 to December 2005 were used as control group. Results There was no statistical difference in aspects of sex, age, injury mechanism, ISS and blood loss in both groups (P ＞0.05). Two patients died in the first track group, with mortality rate of 3% ;while five patients died in the control group, with mortality rate of 11% ( P ＜ 0.05 ). Compared with the control group, there was shorter time in emergency room care, special examination and interval from admission to operating room in fast track group ( P ＜ 0.05 ). Conclusion First-aid fast track can shorten the space and time in treatment of severe trauma, decrease the mortality rate, enhance success rate of treatment and hence guarantee chronergy and integrity of emergency trauma care.

Objective To investigate the changes of intestinal barrier function of patients with multiple injuries,and explore the relationship between the changes and Systemic Inflammatory Response Syndrome(SIRS).Methods Fifty two patients with multiple injury admitted to our hospital from Aug.2007 to May 2008 were divided into mild injury group(n=24,ISS0.05),while obvious increasing existed in moderate and severe groups at 1st day after trauma(P

Several specialized branches are inclusive in the department of trauma surgery,and the instruction of medical ethics during the practice of trauma surgery surely contributes to raise the integrated diathesis and capability for medical students.Common ethical issues in trauma surgery practice include ethics of operative principles,conflict between trauma sufferers and accident-makers,privacy preservation,decision making,and the principles of clinical pharmaceutical trials,etc.It is believed that advantageous principles and independence principles should be overall carried out during the instructional course of medical ethics education.