Objective To study the application effect of quality control circle(QCC)in reducing the dissatisfaction rate of physical examination clients in health management center.Methods To establish QCC,selected the health check-up popula-tion in our hospital in September-2019 and March-2020,through the questionnaire investigation and analysis,compare the dis-satisfaction of the clients before and after the quality control circle.Results After carrying out QCC activities,the dissatisfaction of physical examination clients was significantly lower than that before QCC,and the difference was statistically significant(P＜0.05).Conclusion The activities of QCC in the health management center can effectively improve the quality of the physical examination work and reduce the dissatisfaction of the customers in the physical examination.It is of great significance to the health management.

Objective:To summarize the best evidence for non-pharmacological interventions for patients with perimenopausal sleep disorders and to provide an evidence-based basis for improving sleep disorders and quality of life in perimenopausal women.Methods:All the evidence of sleep disorder in perimenopausal period in databases were searched by the computer in UpToDate, BMJ Best Clinical Practice, Cochrane Library, Joanna Briggs Institute Database, National Guideline Cleaninghouse, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Wanfang Database, CNKI, et al. The evidences includes guidelines, expert consensus, evidence summary, systematic evaluation, best practice information book, randomized controlled trial, etc. The search deadline was from database establishment to October 15, 2022. Finally, methodological quality evaluation was conducted on relevant literature to extract and integrate the best evidence.Results:A total of 22 literatures were included, including 6 guidelines, 1 position statement, 4 systematic reviews and 11 randomized controlled trials. A total of 21 pieces of evidence were collected from 5 aspects, including sleep assessment, psychological intervention, physical intervention, traditional Chinese medicine intervention and exercise intervention.Conclusions:Regular evaluation should be conducted on the sleep status of perimenopausal women, and appropriate and feasible individualized intervention measures should be provided based on the actual situation to improve their sleep quality. When applying evidence, it should be combined with the clinical environment to transform it into localized evidence to guide best practice.

BACKGROUND:Subdermal contraceptive implants as a novel contraceptive method have been extensively used worldwide.OBJECTIVE:To review the research progress in the non-biodegradable and biodegradable long-term subdermal contraceptive implants and to explore their advantages and disadvantages.METHODS:A computer-based search of CNKI,Wanfang,and PubMed (1967-2015) was performed by the first author for relevant articles,using the key words of contraceptive implants,non-biodegradable,biodegradable in Chinese and English,respectively.Initially 240 articles were retrieved,and finally 70 articles were included in result analysis.RESULTS AND CONCLUSION:Long-term subdermal contraceptive implants that pass through the local capillaries into the blood circulation system can avoid the gastrointestinal absorption,improve the bioavailability of drugs,and reduce adverse drug reactions.According to the performance,there are two kinds of drug carriers,non-biodegradable and biodegradable.Although non-biodegradable implants have been widely used and the contraceptive effect is excellent,the implants must be removed surgically because they cannot be absorbed or metabolized in the body.Significant efforts have been devoted to developing biodegradable implants because they can degrade at the end of use.However,the utility of some biodegradable polymers as drug carriers in implantable applications has been hampered by their shortcomings,and further study on alternative materials is urgently required.

BACKGROUND:Currently, biodegradable polymer materials such as poly(morpholine-2, 5-dione) and its derivatives have been widely used in biomedical field to fabricate nerve catheters, tissue engineering and drug control release carriers. Therefore, many research has focused on the synthesis of poly(morpholine-2 5-dione) and its derivatives.
OBJECTIVE:To review the synthesis methods of monomeric and polymeric morpholine-2, 5-dione and its derivatives, and to explore its advantages and shortcomings. METHODS:A computer-based search of databases of Wanfang, CNKI, SCI and PubMed was performed for relevant articles published from 1982 to 2015. And the keywords were“morpholine-2, 5-dion, biodegradable”in Chinese and English, respectively. RESULTS AND CONCLUSION:So far, acylation reactions ofα-amino acids andα-halogen halide, the intramolecular esterifications and intramolecular condensation reactions are the key methods for the synthesis of morpholine-2, 5-dione and its derivatives. A modified approach is needed to overcome the existed disadvantages. Ring-opening polymerization of morpholine-2, 5-dione is a preferred method of synthetic polyester-amide, but low molecular weight and conversion of polymers are produced. Polymerization catalyzed via metal compounds and enzymes are the best strategy for the synthesis of poly(morpholine-2, 5-dione). Furthermore, as a valuable biodegradable polymer material, poly(morpholine-2, 5-dione) has been extensively applied in the medical field.

Objective To explore somatic symptoms of patients with functional dyspepsia (FD) and effects of combined anti somatisation therapy on the quality of life in patients with FD.Methods Two hundred and nineteen patients with FD were enrolled.Patient Health Questionnaire-15 (PHQ-15) and Nepean Dyspepsia Index (NDI) were completed,and the relation between them was analyzed.Lansoprazole,mosapride and flupentixol melitracen (the anti-somatisation medication) were taken for four weeks by 131 FD patients who had poor response to four-week conventional treatment with proton pump inhibitors (PPI) and/or prokinetic medication and who got more than 4 scores in PHQ 15.And then therapeutic effects were observed and the changes of NDI before and after treatment were analyzed.The t test,chi-square test,Spearman's correlation and linear regression were performed for statistical analysis.Results The total PHQ-15 and NDI score of 219 patients with FD were 5.7±3.4 and 42.0± 10.4,and there was positive correlation between them (r=0.493,P＜0.05).Stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder,thirst and so on were positively correlated with totalNDIscore (r=0.262,0.230,0.241,0.243,0.352,0.385,0.266,0.281,all P＜0.05).Chest pain,stomach pain,shortness of breath,dizziness and fatigue were the influence factors of NDI (t=2.340,2.488,5.278,2.167,2.443,all P＜0.05).Among 131 patients with FD who received anti somatisation combination therapy,six patients did not complete the therapy because of the side effects,and finally 125 patients were enrolled and analyzed.Before and four weeks after the treatment,the total PHQ-15 scores of 125 patients with FD were 7.3±3.2 and 2.9±2.2,respectively; and the difference was statistically significant (t =12.653,P＜0.01).There were significant differences in the influence of stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder and thirst before and after the treatment (not bothered at all,bothered a little,bothered a lot) (x2=39.231,6.796,6.693,15.520,6.698,51.572,44.390 and 16.506,all P＜0.05).The total NDI score before and after the treatment were 44.3 ± 11.7 and 29.2 ± 6.9,and the difference was statistically significant (t=12.503,P＜0.01).Conclusions The quality of life in patients with FD is affected by somatic symptoms such as chest pain,stomach pain,shortness of breath,dizziness,fatigue and so on.For FD patients with poor response to conventional treatment,the quality of life could be improved by the combination of anti-somatisation therapy and the conventional therapy.

Cartilage, Articular ; metabolism ; Humans ; Osteoarthritis, Knee ; blood ; Platelet-Rich Plasma ; metabolism

Objective To determine the population structure of Streptococcus pncumoniae isolates collected from infants with eye infections,including drug resistance,resistance genes, serotypes and molecular types.Methods The susceptibility of 39 isolates to 10 antibacterial agents was tested by K-B disk diffusion and Etest.Latex agglutination test was performed to determine the serotype of the strains,and PCR was carried out to detect macrolides resistance genes mefE and ermB.Molecular types of the 20 strains were determined by multilocus sequence typing (MLST).Results A total of 39 Streptococcus pneumoniae isolates were obtained,in which 30 (76.9％) were resistant to 3 or more antibacterial agents,and no vancomycin,penicillin or cefotaxime resistant strain was found.ermB gene was found in 33 strains and mefE gene was found in 4 strains.Twelve serotypes were found,and the most frequent serotypes were 19 (8/39) and 14 (4/39). Seventeen strains (43.6％) were covered in PCV7 vaccine. The international clone Taiwan19F-14 and Spain23F-1 were found by MLST. Conclusions Streptococcus pneumoniae isolates from infants with eye infections include international resistance clones.The distribution of serotype and molecular type are dispersed, and the clones are sporadic. The isolates are highly resistant to commonly used antibacterial agents.

The high occurrence of neural invasion in pancreatic carcinoma, which can be as much as 90%-l00%,leads to the poor survival rate in patients. The classical pathology includes invasion of both the extrapancreatic and intrapancreatic neurons. Metastasis into the extrapancreatic plexus promotes invasion into the intrapancreatic neurons and therefore results in pain. An increased in the diagnosis of new-onset diabetes mellitus, on the other hand, correlates with an increase in pancreatic cancer. This implies that hyperglycemia may promote neural invasion of pancreatic carcinoma. Novel auxiliary therapy of pancreatic carcinoma with neural invasion includes controlling of blood sugar and optogenetics, a new genetic technology which can further be utilized for surveillance.

Aseptic loosening of the prosthesis due to periprosthetic osteolysis is one of the main causes that affect the service life following artificial joint replacement. The patient should undergo revision of artificial joints,but the surgery is of high difficulty,high risk and excessive cost,etc. Therefore,using nonsurgical technique to control artificial prosthesis osteolysis is an urgent and realistic task. Currently,the drug prevents osteolysis through inhibiting osteoclast bone resorption,responding to cytokines,and promoting bone formation. In addition,gene therapy and other treatments for osteolysis are under exploration.

[Objective]To observe the change of ultrapathology in the rat model study of experimental lumbar intervertebral disc degeneration.[Method]Thirty-two Sprague-Dawley(SD)rats were divided into two guoups at random,including in the experimental group and the control group.The experimental group was incised through posterior approach along spinous process,resected below erector spinal muscle,the supraspinal and interspinal ligament and the posterior of the zygapophysial joint at the center of the third lumbar spine for providing the rat degeneration of lumbar intervertebral induced by mechanical instability state.The control group was just incised the skin.All of th rats were examined after eight weeks by electronmicroscope.[Result]There was no special ultrapathological characterization after operation in the control group,while in experimented group most chonduocyte-like cells were degenerated or necrotic and their number decreased markedly,collagenous fibrils appeared various kinds of degeneration including fusion,twist and calcification,and there were gaps between the collagen bundles.[Conclusion]Observing the change in the rat model study of experimental lumbar intervertebral disc degeneration by ultrapathology,it can offer the experimental data studying tile degeneration of lumbar intervertebral disc.