Objective:To study the application effect of prospective management based on failure cause analysis in optimizing the maintenance efficiency of digestive endoscope.Methods:The failure phenomena and causes of digestive endoscope were analyzed,basic management measures and common failure management countermeasures were formulated to carry out prospective management of digestive endoscope.The data of 43,866 operations of from 8 digestive endoscopes in clinically use from 2021 and 2022 in Department of Gastroenterology of The PLA Rocket Force Characteristic Medical Center were collected,and according to different management modes of digestive endoscope,the conventional management mode(21,737 times)and prospective management mode based on failure cause analysis(22,129 times)were adopted respectively.The differences in the incidence of digestive endoscope failure,maintenance grade(grade A,grade B,grade C,grade D and grade E)and the standardized evaluation(13 aspects in 3 dimensions)of the two management modes were compared.Results:The incidence rate of digestive endoscope failure in the prospective management mode was 0.15%(33/22,129),which was lower than that in the conventional management mode,the difference was statistically significant(x2=13.390,P<0.05).In the 33 times of digestive endoscope maintenance in the prospective management mode,the incidence rates of grade A,grade B,grade C,grade D and grade E maintenance were 12.12%(4/33),36.36%(12/33),27.27%(9/33),18.18%(6/33)and 6.06%(2/33),respectively,the maintenance grade data was better than that in the conventional management mode,the difference was statistically significant(Z=2.263,P<0.05).In the standardized evaluation of digestive endoscopes managed by the prospective management mode,the operation error rate was lower than that of conventional management mode,the difference was statistically significant(x2=4.110-34.909,P<0.05).Conclusion:The application of maintenance efficiency of digestive endoscopes by prospective management optimization based on fault cause analysis can reduce failure rate of digestive endoscopy and improve the standard use rate of digestive endoscopy.

Background::Atopic dermatitis (AD) affects approximately 10% of adults worldwide. CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling. This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD.Methods::This multicenter, randomized, double-blind, placebo-controlled, phase 2b trial was conducted in 21 medical institutions in China from February to November 2021. Totally 120 eligible patients were enrolled and randomized (1:1:1) to receive subcutaneous injections of 300 mg CM310, 150 mg CM310, or placebo every 2 weeks for 16 weeks, followed by an 8-week follow-up period. The primary endpoint was the proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (EASI-75) score from baseline at week 16. Safety and pharmacodynamics were also studied.Results::At week 16, the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups (70% [28/40] for high-dose and 65% [26/40] for low-dose) than that in the placebo group (20%[8/40]). The differences in EASI-75 response rate were 50% (high vs. placebo, 95% CI 31%–69%) and 45% (low vs. placebo, 95% CI 26%–64%), with both P values <0.0001. CM310 at both doses also significantly improved the EASI score, Investigator’s Global Assessment score, daily peak pruritus Numerical Rating Scale, AD-affected body surface area, and Dermatology Life Quality Index compared with placebo. CM310 treatment reduced levels of thymus and activation-regulated chemokine, total immunoglobulin E, lactate dehydrogenase, and blood eosinophils. The incidence of treatment-emergent adverse events (TEAEs) was similar among all three groups, with the most common TEAEs reported being upper respiratory tract infection, atopic dermatitis, hyperlipidemia, and hyperuricemia. No severe adverse events were deemed to be attributed to CM310. Conclusion::CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.Trial Registration::ClinicalTrials.gov, NCT04805411.

Objective To explore the effect of residual tissue glue in forceps channels on the disinfection quality of digestive endoscopes. Methods A total of 103 forceps channels of digestive endoscopes in the Digestive Endoscopy Center of the hospital from March 2022 to June 2023 were randomly selected, and the residual situation of tissue glue in the forceps channels of the endoscopes was observed after cleaning and disinfection. The endoscopes were divided into residual group and non-residual group based on the residual situation of tissue glue in the forceps channels, the disinfection quality and microbial conditions of digestive endoscopes in both groups were detected, and the factors affecting the disinfection quality of digestive endoscopes were analyzed. Results Among the 103 forceps channels, 70 channels (67.96%) had residual tissue glue; the disinfection qualification rate and bacteriological qualification rate of the non-residual group were significantly higher than those of the residual group (P<0.05). There were four personnel carrying out disinfection, and the proportion of qualified disinfection water quality was higher than that of poor group (P<0.05). Conclusion The higher the residual rate of tissue glue in forceps channels and the bacterial detection rate are, and the lower the disinfection quality of digestive endoscopes is. The quality of disinfection water and the number of disinfection personnel can affect the disinfection quality of digestive endoscopes.

Objective To investigate the commissioning and testing of the Eclipse model of an Edge accelerator with high-definition muhi-leaf collimator (HD-MLC).Methods The percentage depth dose (PDD),profile,output factor measured by Razor and CC13 were statistically compared with the standard data.Penumbra,transmission factor (TF),leakage,concave-convex groove,accuracy of movement and dosimetry leaf gap (DLG) were measured with EBT3,electronic portal image device (EPID) and PTW SRS1000&SRS1500.The optimal DLG/TF was acquired when the γ pass rate of test cases was the highest.The point dose of regular fields,intensity-modulated radiation therapy (IMRT) and volume-modulated radiation therapy (VMAT) was verified with FC65-G.The planar dose of these case was verified with Octavius 4D and EBT3.Results The measured PDD data were consistent with the standard data.The measured penumbra of 3 cm and 4 cm square fields was smaller,whereas that of 6 cm square field was larger than the standard values.The left and right edge,field size,center of the field were distributed within the range of-1.0-0.4 mm、0.2-1.7 mm,-0.3-1.9 mm and-0.1-0.8 mm,respectively.The mean penumbra of the left and right MLC in different positions were (2.5±0.042) mm and (2.7±0.005) mm.The leakage of MLC was 0.009-0.016.The measured DLG/TF was 0.1861 cm/0.0116 and the optimal DLG/TF was 0.015 cm/0.014.The differences of point dose of all the test cases except the one which was in the low-dose area were within ±3％.Local and global γ pass rates of all IMRT were 79.81％-100％ and 96.3％-100％ (3％/3 mm),71.3％-98.9％ and 94.3％-99.8％ for VMAT cases.Conclusions This method can accurately test and commission the Eclipse treatment planning model of Edge Linac equipped with HD-MLC.

Objective To investigate the expression of plasma microRNA-214 in patients with acute myocardial infarction (AMI) and its correlation with left ventricular remodeling (LVR). Methods A total of 158 AMI patients and 85 controls were selected from Hebei province Zhuozhou City Hospital. According to the left ventricular remodeling after PCI operation, AMI patients were divided into LVR group (n=41) and non LVR group (n=105). Real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the plasma microRNA-214 levels, and the brain natriuretic peptide (BNP) and C-reactive protein (CRP) levels were detected by immunoassay. Pearson correlation analysis of plasma microRNA-214 levels and the correlation between CRP and BNP were analyzed in patients with LVR. The receiver operating characteristic (ROC) curve analysis of plasma microRNA-214, BNP and CRP were used to predict the efficacy of LVR in patients with AMI after PCI. Logistic regression model was used to analyze the relationship between the above indexes and LVR. Results Compared with the control group, left ventricular ejection fraction (LVEF) and left ventricular short axis shortening (FS) were significantly decreased in LVR group and non LVR group, and which were decreased more significantly in LVR group compared with those of non LVR group (P<0.05). The left ventricular end diastolic diameter (LVDD), left ventricular end diastolic volume (LVEDV) and left ventricular end systolic volume (LVESV) were significantly increased in LVR group and non LVR group, and which were increased more significantly in LVR group than those in non LVR group (P<0.05). The levels of plasma microRNA-214, BNP and CRP were significantly higher in LVR group than those in non LVR group and control group (P<0.05). Correlation analysis showed that microRNA-214, BNP and CRP were positively correlated in patients with LVR (r=0.684 and r=0.405, P<0.01). The area under ROC curve (AUC) and 95%CI predicted by plasma microRNA-214 and BNP were 0.824 (0.757-1.015) and 0.785 (0.721-0.864) in patients with AMI and LVR, which were higher than CRP [0.716 (0.645-0.837), P=0.0167]. The sensitivity and specificity of plasma microRNA-214 in predicting the occurrence of LVR were 72.6% and 86.2% in patients with AMI, respectively. Logistic regression model analysis showed that plasma microRNA-214 and BNP were risk factors of LVR. Conclusion High expression of plasma microRNA-214 is found in LVR patients, which is expected to be the biological indicator for predicting the occurrence of LVR after PCI in patients with AMI.

Objective To explore and analyze the quality of life and family care in elderly patients with type 2 diabetes and their correlation, and to offer a basis for making family care plans after being discharged from hospital.Methods Totally 441 elderly patients with type 2 diabetes between July 2014 and June 2016 were investigated with the Simplified Health Questionnaire (SF-36) and Family APGAR Index, and the Pearson correlation analysis was conducted on their correlation.Results The patients scored (6.27±1.74), (535.46±22.33) and (3.35±0.83) in family care, quality of life and health transition, respectively. Family care was positively correlated with the eight dimensions indicating quality of life (r=0.138-0.660,P<0.01), and negatively correlated with health transition (r=-0.100,P<0.05).Conclusions Elderly patients with type 2 diabetes show a low quality of life, and their family function is between moderately dysfunctioning and well-functioning. Therefore, the hospital, community, family and individual need to work together to improve patients' family function and quality of life.

OBJECTIVE:To observe the efficacy and safety of scopolamine butylbromide in the adjuvant treatment of gastric ul-cer. METHODS:The data of 160 patients with gastric ulcer were retrospectively analyzed and randomly divided into tradition group and combination group. Tradition group was orally treated with acid suppression,hemostasis and other conventional treatment. Based on the treatment of tradition group,combination group was treated with Scopolamine butylbromide for injection 20 mg by in-tramuscular injection,once a day,for continuous 7 d,continue conventional treatment after 7 d. The treatment course was 8 weeks. The clinical efficacy,different complete relief patients with abdominal pain in different time,and the recurrence rate after 1 year in 2 groups were observed,and the incidence of adverse reactions were recorded. RESULTS:The total effective rate in combination group was significantly higher than tradition group,recurrence rate was significantly lower than tradition group,different complete relief patients with abdominal pain in different time were significantly better than tradition group,the difference was statistically sig-nificant(P<0.05). There were no obvious adverse reactions in 2 groups during treatment. CONCLUSIONS:Based on the conven-tional treatment,scopolamine butylbromide can be used in the adjuvant treatment of gastric ulcer. It can obviously shorten the time of abdominal pain in patients with gastric ulcer and reduce the recurrence rate,with good safety.

BACKGROUND:Studies have shown that bone marrow mesenchymal stem cells have the ability to persistently generate hepatocytes and biliary cells, and thus in the repair process of liver injury, replenish the reduced number of hepatocytes due to damage and participate in damaged liver structure.
OBJECTIVE:To investigate the effect of bone marrow mesenchymal stem cells transplantation on acute liver failure and the expression of CD163 and interleukin-10 in rat serum and liver tissue.
METHODS:D-galactose and lipopolysaccharidewere used to make acute liver failure models in 60 Sprague-Dawley rats. Then, the rats were divided into control group and transplantation group. Bone marrow mesenchymal stem cells at passage 3 were injected through tail vein in the transplantation group, and normal saline was injected in the control group. After transplantation 24, 120, 168 hours, serum samples and liver tissues were col ected.
RESULTS AND CONCLUSION:After transplantation 120 and 168 hours, the serum alanine transaminase and aspartate aminotransferase activities of the transplantation were significantly lower than those of the control group (P<0.05). In the transplantation group the apoptotic index was stil lower compared with the control group, and the difference was significant (P<0.05). The levels of CD163 and interleukin-10 in the serum and liver tissue in the transplantation group were decreased significantly compared with the control group (P<0.05). The results suggested that there were highly significant correlations between CD163 and interleukin-10 (P<0.01). Bone marrow mesenchymal stem celltransplantation has a therapeutic effect on acute liver failure rats. CDl63 and interleukin-10 play a very important role in the pathogenesis of acute liver failure, which can be used as sensitive serum marker proteins for diagnosis and prognosis of acute liver failure.

Adult ; Age Factors ; Alcoholism ; complications ; China ; epidemiology ; Fatty Liver ; epidemiology ; etiology ; Female ; Humans ; Liver Diseases, Alcoholic ; epidemiology ; etiology ; Male ; Middle Aged ; Prevalence ; Sex Factors