Objective:To explore the application effect of theory of inventive problem solving(TRIZ)in the management of loaner instruments in central sterile supply department(CSSD).Methods:TRIZ management team was set up to analyze problems in cleaning,disinfection and sterilization of loaner instruments.The invention principles of TRIZ were compared to determine targeted solutions to the corresponding problems.A total of 1,000 pieces of loaner instruments received by The Third Affiliated Hospital of Air Force Medical University were selected from January and December 2023 were selected,the 500 pieces received from January to June were managed by routine standard management mode,and the 500 pieces received from July to December were managed by the TRIZ management mode.The qualification rates of instruments cleaning,disinfection,packaging and sterilization,the incidence of adverse events,the satisfaction scores of clinical departments and assessment results of newly hired nurses of CSSD were compared between the two management modes.Results:The qualification rates of instruments cleaning,disinfection,packaging and sterilization of TRIZ management mode were 98.00%(490/500),97.20%(486/500),96.40%(482/500)and 96.00%(480/500),respectively,which were higher than those of routine standard management mode,the difference was statistically significant(x2=12.029,11.685,8.859,8.322,P<0.05).The incidence of adverse events of TRIZ management mode was 0%,the routine standard management mode was 1.20%,the difference was statistically significant(x2=6.036,P<0.05).The average scores of CSSD newly hired nurses in of theoretical knowledge,treatment process,cleaning,disinfection and sterilization and packaging of TRIZ management mode were(89.20±6.69)points,(88.47±3.48)points,(92.47±5.37)points and(92.00±5.83)points,respectively,which were higher than those of routine standard management mode,the difference was statistically significant(t=3.993,4.402,3.926,3.332,P<0.05).The satisfaction scores of clinical department personnel with instruments quality,distribution,handover,information traceability,service attitude and overall satisfaction of TRIZ management mode were(18.65±0.81)points,(18.85±1.04)points,(18.95±1.05)points,(18.40±0.75)points,(18.35±0.93)points and(93.20±1.91)points,respectively,which were higher than those of the routine standard management mode,the difference was statistically significant(t=3.599,5.889,4.851,4.865,2.075,8.723,P<0.05).Conclusion:The application of TRIZ in the management of loaner instruments in CSSD can significantly improve theoretical knowledge and practical skills of newly hired nurses in CSSD,thereby improving the qualification rates of instruments cleaning,disinfection,packaging and sterilization of loaner instruments,reducing the occurrence of instrument-related adverse events and improving satisfaction of department personnel with instruments use.

Objective:To establish and preliminarily validate a nomogram model for predicting the risk of retinal vein occlusion (RVO).Methods:A retrospective clinical study. A total of 162 patients with RVO (RVO group) diagnosed by ophthalmology examination in The Second Affiliated Hospital of Xi'an Jiaotong University from January 2017 to April 2022 and 162 patients with age-related cataract (nRVO group) were selected as the modeling set. A total of 45 patients with branch RVO, 45 patients with central RVO and 45 patients with age-related cataract admitted to Xi'an Fourth Hospital from January 2022 to February 2023 were used as the validation set. There was no significant difference in gender composition ratio ( χ2=2.433) and age ( Z=1.006) between RVO group and nRVO group ( P=0.120, 0.320). Age, gender, blood routine (white blood cell count, hemoglobin concentration, platelet count, neutrophil count, monocyte count, lymphocyte count, erythrocyte volume, mean platelet volume, platelet volume distribution width), and four items of thrombin (prothrombin time, activated partial thrombin time, fibrinogen, and thrombin time) were collected in detail ), uric acid, blood lipids (total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, lipoprotein a), hypertension, diabetes mellitus, coronary heart disease, and cerebral infarction. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were calculated. The single logistic regression was used to analyze the clinical parameters of the two groups of patients in the modeling set, and the stepwise regression method was used to screen the variables, and the column graph for predicting the risk of RVO was constructed. The Bootstrap method was used to repeated sample 1 000 times for internal and external verification. The H-L goodness-of-fit test and receiver operating characteristic (ROC) curve were used to evaluate the calibration and discrimination of the nomogram model. Results:After univariate logistic regression and stepwise regression analysis, high density lipoprotein, neutrophil count and hypertension were included in the final prediction model to construct the nomogram. The χ2 values of the H-L goodness-of-fit test of the modeling set and the validation set were 0.711 and 4.230, respectively, and the P values were 0.701 and 0.121, respectively, indicating that the nomogram model had good prediction accuracy. The area under the ROC curve of the nomogram model for predicting the occurrence of post-stroke depression in the modeling set and the verification set was 0.741 [95% confidence interval ( CI) 0.688-0.795] and 0.741 (95% CI 0.646-0.836), suggesting that the nomogram model had a good discrimination. Conclusions:Low high density lipoprotein level, high neutrophil count and hypertension are independent risk factors for RVO. The nomogram model established based on the above risk factors can effectively assess and quantify the risk of post-stroke depression in patients with cerebral infarction.

Objective:To investigate the standardization construction of nursing information terminologies in Guizhou Province and provide reference for constructing a standard nursing terminology system in Guizhou Province.Methods:Using the convenient sampling method, a total of 153 nursing managers from hospitals at all levels in Guizhou Province were selected as the research objects in June, 2021. The research objects were surveyed using a self-developed survey questionnaire on the current status of standardized terminology construction for hospital nursing information. The questionnaire consisted of two parts. The first part was the basic information of the hospital and the general information of the person in charge of nursing information. The second part was the construction of standardized terminology for nursing information, including three dimensions, such as the basic dataset of nursing electronic medical records, the shared document of nursing electronic medical records and the construction of nursing information terminologies interconnection. Multiple linear regression analysis was used to analyze the influencing factors of standardized construction of nursing information terminologies. A total of 153 questionnaires were distributed in this study and 148 valid questionnaires were collected, with an effective response rate of 96.73% (148/153) .Results:The total score of the survey questionnaire on the standardization of nursing information terminologies construction in 148 hospitals in Guizhou Province was (102.22±24.42) . The basic dataset dimension score of nursing electronic medical records was (60.35±13.32) , the shared document dimension score of nursing electronic medical records was (27.78±19.08) and the dimension score of nursing terminology interconnection construction was (14.08±2.71) . The results of multiple linear regression analysis showed that hospital level and whether nursing managers had received terminology training were the influencing factors for the score of hospital nursing information standardization terminology construction ( P<0.05) . Conclusions:The standardization construction of nursing information terminologies in medical institutions in Guizhou Province is still at the primary level of information construction. The insufficient attention paid by secondary hospital managers to the standardization construction of nursing information terminologies and the lack of understanding of standardized nursing terminology by nursing information managers are important influencing factors.

Objective To analyze the levels of IgE,TNF-α and FeNO in children with acute attack of bronchial asthma and their correlation with the severity of bronchial asthma, so as to provide theoretical basis for clinical evaluation of bronchial asthma. Methods A total of 547 children with acute bronchial asthma treated in Chengdu Women and Children's Central Hospital from January 2020 to December 2020 were selected and divided into mild group (n=287), moderate group (n=186) and severe group (n=74) according to the severity of their disease. All the children's symptoms were controlled after treatment. The serum IgE, TNF-α and FeNO levels in the experimental group were compared between the acute attack stage and the clinical control stage. Spearman correlation analysis was used to analyze the correlation between the serum IgE, TNF-α and FeNO levels and the severity of the disease. ROC curve of children with bronchial asthma was drawn to analyze the differential diagnosis value of serum IgE, TNF-α and FeNO levels in children with acute bronchial asthma. Results The levels of IgE, TNF-α and FeNO in acute stage were significantly higher than those in clinical control stage (P<0.05). The levels of serum IgE, TNF-α and FeNO in severe group were higher than those in mild and moderate groups significantly (P<0.05). The levels of serum IgE, TNF-α and FeNO in moderate group were higher than those in mild group significantly (P<0.05). Spearman correlation analysis showed that serum IgE, TNF-α and FeNO water were positively correlated with the severity of bronchial asthma (r=0.419 , 0.438 , 0.502 , P<0.05). ROC curve analysis showed that the AUC, sensitivity, accuracy and specificity of serum IgE, TNF-α and FeNO levels combined in diagnosing the severity of bronchial asthma in patients with acute attack was 0.938 (95% CI: 0.912-0.982 ), 83.47%, 92.06%, 94.28%. Conclusion The level of serum IgE, TNF-α and FeNO in children with acute attack of bronchial asthma is closely related to the severity of the disease, and combined detection of the three can be used to evaluate the severity of the disease in children.

Mitochondrial shape rapidly changes by dynamic balance of fusion and fission to adjust to constantly changing energy demands of cancer cells. Mitochondrial dynamics balance is exactly regulated by molecular motor consisted of myosin and actin cytoskeleton proteins. Thus, targeting myosin-actin molecular motor is considered as a promising strategy for anti-cancer. In this study, we performed a proof-of-concept study with a natural-derived small-molecule J13 to test the feasibility of anti-cancer therapeutics

Teaching rounds is an important part of clinical teaching practice, therefore, we established a demonstration team for teaching ward rounds. By formulating standard operation procedure for teaching rounds and encouraging innovation on teaching models, the team played a demonstration role in the clinical teaching rounds, which not only made up the shortcomings in teaching, but also improved the teaching level of clinical teachers and the quality of clinical training.

OBJECTIVE:To evaluate the improvement and rectification effects about prescription checking and intervention skills of pharmacists. METHODS:By retrospective investigation,2417 outpatient prescriptions and 1698 outpatient prescriptions were respectively selected from some one hospital during Oct.-Dec. 2015 (before improvement and rectification) and Jan.-Mar. 2016 (after improvement and rectification). According to standards,guidelines and references as Prescription Administrative Poli-cy,Prescription Review Management Standard(trial)and drug instructions,irrational drug use and prescription checking and inter-vention skills of pharmacists were compared before and after the implementation of rectification measures as optimizing hospital in-formation system,improving comprehensive skills of pharmacists,strengthening pharmacists'concept,establishing feedback mech-anism. RESULTS:After the implementation of rectification measures,unsuitable indications,clinical diagnosis inconsistent with medication,antibiotics use without indications,unsuitable usage and dosage,unsuitable drug combination and irrational drug use were all decreased,but repeated drug use was increased,without statistical significance (P>0.05). The number of non-standard prescriptions and unsuitable prescriptions checked by pharmacists were decreased,without statistical significance(P>0.05). The in-cidence of checking missing,excessive checking and checking error were all increased from 2.40%,0.99%,3.39% before im-provement and rectification to 0.47%,0.29%,0.77%,with statistical significance(P<0.05). CONCLUSIONS:The improvement and rectification measures of the hospital can improve comprehensive prescription checking and intervention skills of pharmacists. Ir-rational drug use should be further standardized.

Objective To investigate the technical requirements for the 3.0T multi-modal quantitative MR imaging of the rabbit liver.Methods A total of 8 rabbits were scanned and T1 mapping,T2 mapping,MT and Gd EOB-DTPA dynamic enhancement images were acquired.For the dynamic enhanced scanning,injecting contrast medium was followed by saline flush with different combinations of injection flow rate (1.5 mL/s and 2 mL/s) and injection volume(6 mL and 8 mL).The quality of the images was assessed and analyzed statistically.Results The total scanning time was about 20-25 min.High-quality images were acquired by T1 mapping,T2 mapping and MT sequences.There was no significant difference in image quality among different groups in Gd-EOB-DTPA dynamic enhanced scanning(P＞0.05).Two rabbits died when the combination of injection flow rate of 2 mL/s and injection volume of 8 mL was used.Conclusion 3.0 T multi-modal quantitative MR scanning of rabbit liver can be achieved successfully if scanning parameters are properly chosen.

OBJECTIVE:To establish a method for full-length cDNA library of Xinjiang Artemisia rupestris. METHODS:Mod-ified Trizol method was adopted to extract total RNA in young leaves of A. rupestris,it was transcribed into single-strand cDNA, and then synthesized into double-strand cDNA by long-distance polymerase chain reaction(LD-PCR)method. PCR product was di-gested by proteinase K and sfiⅠ,and then fractionated by CHROMA SPIN-400 columns. The cDNA longer than 0.4 kb were col-lected and ligated to phage λTriplE × 2,and then protein packaging was performed. Full-length cDNA library was established by SMART technology. 20 monoclonal were randomly selected from the library,and electrophoresis was used to determine the primary library titer,library capacity,recombinant positive rate and length of insert cDNA. RESULTS:The primary library titer was 1.94× 107 pfu/mL,library capacity was 0.97×107 pfu;recombinant positive rate of insert cDNA was 96% and length was 0.5-2.0 kb with an average of 0.9 kb. CONCLUSIONS:The established library is high in capacity and quality,which can provide basis for estab-lishing cDNA library of Xinjiang A. rupestris.

Objective To explore the effects of postoperative nursing on patients′ postoperative safety and and rehabilitation process after total knee arthroplasty ( TKA ) that based on concept of fast-tract surgery (FTS).Methods Totally 200 patients who had surgery for total knee arthroplasty from January 2013 to July 2014 were randomly assigned to the routine group (n=100) and the FTS group (n=100). Patients in the routine group were received routine postoperative nursing, while patients in the FTS group received optimized postoperative nursing that based on FTS concept. The time to start eating after surgery, VAS pain score, the removal time of urethral catheter and drainage tube, the first off-bed activity time after operation,the recover speed of knee joint function and incidence of postoperative complications were compared between two groups.Results Compared with the routine group, the time to start eating after surgery in the FTS group was (4.56±0.33) h;the removal time of urethral catheter was (15.12±3.43) h; the removal time of drainage tube was (17.43±3.91) h, and they were all shorten ( t=21.82,31.60,14.99;P<0.01) . The pain score in the FTS group within 3 d after surgery was (1.39±1.12), and was lower than that in the routine group (t=10.993,P<0.01); in the FTS group, the first off-bed activity time after surgery was (16.72±2.01)h;the time of actively straight leg raising was (18.2±6.3)h;the time of actively bending knees for 90 degree was (3.5±1.7) h, and they were all markedly advanced (t=57. 23,8.885,4.545;P<0.01) . There were 6 cases of complications that caused by pain in the routine group, while there were none in the FTS group ( P<0.05) . There was no statistically significant difference in cases with other complications between two groups ( P>0. 05 ) . Conclusions Application of optimization postoperative nursing scheme for total knee arthroplasty based on FTS is safe. It can shorten the time to start eating after surgery, reduce postoperative pain levels, promote the postoperative early ambulation, and has no adverse effect on the incidence of postoperative complications.