【Objective】 To explore the relationship between the storage time of leukodepleted red blood cells and transfusion adverse reactions by analyzing the occurrence of transfusion adverse reactions of patients after leukodepleted red blood cells transfusion from four hospitals. 【Methods】 By using the electronic medical record management system, the collection and transfusion dates of leukodepleted red blood cells from four hospitals in Enshi Prefecture from 2018 to 2022, as well as the information on transfusion adverse reactions, were retrieved. 【Results】 From 2018 to 2022, a total of 697 61 bags of leukodepleted red blood cells were transfused in four hospitals, resulting in 166 cases of transfusion adverse reactions, among which 93 were allergic reactions, 63 were non hemolytic febrile reactions, and 10 were others, with a total incidence rate of transfusion adverse reactions at 0.24%. The average storage time of leukodepleted red blood cells with and without transfusion adverse reactions was (20.25±6.31) and (19.88±5.50) days, respectively. With a storage time of 7 days as the threshold, the incidence of transfusion adverse reactions was the lowest for a storage time of 15~21 days. The incidence of transfusion adverse reactions of leukodepleted red blood cells in two groups (with storage days ≤21 days and >21 days) was not statistically significant(P>0.05). 【Conclusion】 Allergic reactions were the main type of transfusion adverse reaction caused by leukodepleted red blood cells, and the incidence of transfusion adverse reactions decreased and then increased with the prolongation of the storage time of leukodepleted red blood cells. There was no significant difference in the incidence of transfusion adverse reactions with leukodepleted red blood cells stored for ≤ 21 days and >21 days.

Objective To investigate the incidence rate of pulmonary infection after laparoscopic surgery and related risk factors in patients with hepatocellular carcinoma (HCC) comorbid with liver cirrhosis and portal hypertension (PHT). Methods A retrospective analysis was performed for the clinical data of 105 HCC patients with liver cirrhosis and PHT who underwent laparoscopic surgery in Beijing Ditan Hospital, Capital Medical University, from January 2017 to February 2022. A total of 30 factors that might cause pulmonary infection were recorded, including general information, disease factors, surgical factors, and postoperative factors. Postoperative recovery was observed and the occurrence of pulmonary infection was recorded. The chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups, and the multivariate logistic regression analysis was used to investigate the independent risk factors for pulmonary infection. Results Among the 105 patients, 66 underwent laparoscopic devascularization combined with hepatectomy and 39 underwent laparoscopic devascularization combined with radiofrequency ablation (RFA). The surgery was successful for all patients, with no case of conversion to laparotomy or unscheduled reoperation. No death was observed within 30 days after surgery and during hospitalization, with a median length of hospital stay of 20 days (range 14-25 days). The incidence rate of pulmonary infection was 25.71% (27/105). Smoking (odds ratio [ OR ]=3.362, 95% confidence interval [ CI ]: 1.282-8.817, P =0.014), MELD score ( OR =3.801, 95% CI : 1.007-14.351, P =0.049), tumor location ( OR =1.937, 95% CI : 1.169-3.211, P =0.010), surgical procedure ( OR =0.006, 95% CI : 0.001-0.064, P =0.000), intraoperative infusion volume ( OR =4.871, 95% CI : 1.211-19.597, P =0.026), and postoperative pleural effusion ( OR =9.790, 95% CI : 1.826-52.480, P =0.008) were independent risk factors for pulmonary infection. Conclusion There is a relatively high risk of pulmonary infection in HCC patients with liver cirrhosis and PHT undergoing laparoscopic surgery. Postoperative pleural effusion is the high risk factor for pulmonary infection, and devascularization combined with RFA can significantly reduce the risk of pulmonary infection. It is recommended to strengthen preoperative rehabilitation, perioperative liver function maintenance, intraoperative damage control, and goal-oriented fluid therapy and reduce postoperative fluid accumulation in the third space, so as to reduce the incidence rate of pulmonary infection.

Objective:To develop a scale to assess motivation and use of learning strategies in the course of biochemistry for medical students in the theoretical frame of Zimmerman's cognitive theory.Methods:A total of 62 items was developed in the scale based on the revised motivated strategies for learning questionnaire (MSLQ), and 323 medical students from Shanghai Jiao Tong University School of Medicine were selected as subjects. The collected data were analyzed by item correlation, reliability and exploratory factor analysis.Results:Results of reliability analyses showed that Cronbach's α of the scale and two sub-scales were robust (all greater than 0.8), demonstrating good internal consistency. Results of exploratory factor analysis revealed that three factors in the motivation sub-scale were intrinsic value, self-efficacy and learning anxiety, and eight factors in the strategy sub-scale were critical thinking, organization, rehearsal, learning monitoring, learning planning, learning summarizing, time and study environment management, and peer learning.Conclusion:The reliability and validity of the scale are considered to be good, and the scale is of certain application value to understand self-regulated learning of biochemistry for medical students.

Objective:To investigate the influencing factors of nursing interns' satisfaction with having internship in third-grade class-A hospitals in Luzhou City.Methods:Using self-compiled satisfaction questionnaire and mentor's behavior scale (MBS), the internship situation of nursing interns in third-grade class-A hospitals in Luzhou City were investigated. The collected data were described by SPSS 22.0 and analyzed by binary logistic regression to understand the influencing factors of nurses' satisfaction.Results:A total of 729 questionnaires were distributed and 567 valid questionnaires were recovered, with an effective recovery rate of 77.78%. The MBS scores of 567 nursing interns were (3.54±0.72) and 81.1% (460/567) were satisfied with the clinical internship. The teaching mode ( OR=3.570) and the behavior of mentors ( OR=1.056) were the influencing factors of students' internship satisfaction. Conclusion:During the internship, one-to-one clinical teaching mode should be adopted in the process of internship, for improving students' internship experience. Meanwhile, teachers' behavior should be standardized to improve students' learning satisfaction and clinical teaching quality.

Objective To study the application of refined nursing intervention in prevention of postoperative urethral stricture in patients with hypospadias.Methods A total of 144 patients who underwent hypospadias surgery in our hospital were selected as study subjects,and were divided into control group and observation group by random number table method,with 72 cases per group.Both groups were treated with targeted surgery according to severity and different sites of hypospadias.The patients in the control group performed routine nursing intervention during the perioperative period,while the patients in the observation group were given refined nursing intervention on the basis of the control group.The response rate,incidence rates of postoperative complications and hypospadias were evaluated.Results The total response rate in the observation group was higher than that in the control group (P ＜ 0.05).After nursing,the incidence rate of postoperative complications such as bleeding,urinary fistula,infection,and urine extravasation was lower in the observation group than that in the control group[6.94％ (5/72) vs.(18.06％) (13/72),P ＜0.05).After nursing,the total incidence rate of mild and severe urethral stricture in the observation group was lower than that in the control group [(2.78％ (2/72) vs.12.50％ (9/72),P＜0.05).Conclusion Refined nursing intervention for patients with hypospadias can effectively enhance treatment efficacy,reduce postoperative complications,and prevent urethral stricture,thereby to improve the prognosis of the disease.

Objective To study the application of refined nursing intervention in prevention of postoperative urethral stricture in patients with hypospadias.Methods A total of 144 patients who underwent hypospadias surgery in our hospital were selected as study subjects,and were divided into control group and observation group by random number table method,with 72 cases per group.Both groups were treated with targeted surgery according to severity and different sites of hypospadias.The patients in the control group performed routine nursing intervention during the perioperative period,while the patients in the observation group were given refined nursing intervention on the basis of the control group.The response rate,incidence rates of postoperative complications and hypospadias were evaluated.Results The total response rate in the observation group was higher than that in the control group (P ＜ 0.05).After nursing,the incidence rate of postoperative complications such as bleeding,urinary fistula,infection,and urine extravasation was lower in the observation group than that in the control group[6.94％ (5/72) vs.(18.06％) (13/72),P ＜0.05).After nursing,the total incidence rate of mild and severe urethral stricture in the observation group was lower than that in the control group [(2.78％ (2/72) vs.12.50％ (9/72),P＜0.05).Conclusion Refined nursing intervention for patients with hypospadias can effectively enhance treatment efficacy,reduce postoperative complications,and prevent urethral stricture,thereby to improve the prognosis of the disease.

Objective:To improve the TLC identification method in the quality standard for Yangyin Qingfei granules by identifying paeoniflorin and radix scrophulariae on the same condition plate. Methods:The preparation method for paeoniflorin sample solution in the original standard of TLC identification was improved, the extraction method was water-saturated n-butanol extraction, and the reference crude herb solution of radix scrophulariae was prepared. Simultaneous TLC identification of paeoniflorin and radix scrophular-iae was carried out according to the method described in the original standard. Results:The improved TLC method could be used in the simultaneous identification of paeoniflorin and radix scrophulariae, the spots were clear, and the separation and reproducibility were promising without interference. Conclusion:The improved method is more useful in the quality control of the product with simplified operation.

Objective:To determine the content of self-manufactured and imported lurasidone hydrochloride tablets in order to e-valuate their internal qualities. Methods:The determination of lurasidone hydrochloride tablets was performed by HPLC. The HPLC system consisted of a Waters C8 column (250 mm × 4. 6 mm, 3. 5 μm) and the mobile phase of 0. 05 mol·L-1 phosphate buffer solu-tion (pH 3. 0)-acetonitrile(60∶40), the detection wavelength was 230 nm, the flow rate was 1. 2 ml·min-1 and the column tempera-ture was 40℃, and the injection volume was 20μl. Results:The linear range of lurasidone hydrochloride was 0. 100 8-0. 806 4 mg· ml-1(r=0. 999 5). The average recovery was 99. 95% with RSD of 0. 31%(n=9). Conclusion:The method is simple, rapid, ac-curate, and reliable. The method can determine lurasidone hydrochloride tablets satisfactorily. According to the results, there are few differences among the self-manufactured and imported lurasidone hydrochloride tablets.

Acinetobacter Infections ; drug therapy ; Acinetobacter baumannii ; drug effects ; pathogenicity ; Adult ; Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Burns ; drug therapy ; microbiology ; Cefoperazone ; administration & dosage ; therapeutic use ; Humans ; Middle Aged ; Minocycline ; administration & dosage ; therapeutic use ; Retrospective Studies ; Sulbactam ; administration & dosage ; therapeutic use ; Thienamycins ; adverse effects ; therapeutic use ; Young Adult

OBJECTIVETo explore the epidemiological characteristics of inhalation injury and to summarize the clinical application experience of diagnostic standard of burn of larynx.

METHODSMedical records of 443 patients with inhalation injury admitted to our burn unit from January 1999 to June 2013 were analyzed, including gender, age, severity of inhalation injury, complications and diseases before injury; total area and that of full-thickness burn injury, admission time after burn, and burn condition of larynx of patients with different degrees of inhalation injury; treatment and outcome including rate, time, and complication of tracheotomy, mortality, and cause of death. Data were processed with nonparametric Kruskal-Wallis test and chi-square test. The relationship between severity of inhalation injury and total burn area, degree of burn of larynx, tracheotomy rate, and mortality was assessed by Spearman correlation analysis.

RESULTS(1) Among the patients, there were 353 (79.7% ) male and 90 (20.3% ) female, with the ratio of male to female 4:1. There were 64 (14.4%) patients younger than or equal to 20 years, 203 (45.8%) patients older than 20 years and younger than or equal to 40 years, 144 (32.5%) patients older than 40 years and younger than or equal to 60 years, and 32 (7.2%) patients older than 60 years. The numbers of patients with mild, moderate, and severe inhalation injury were respectively 297, 108, and 38. Seven patients suffered from complications, and 21 patients had diseases before injury. There were statistically significant differences among the patients with different degree of inhalation injury in regard to total burn area and full-thickness burn area (with H values respectively 73.752 and 142.830, P values below 0.01), while no statistically significant difference was observed in admission time after burn ( H = 1.528, P > 0.05). Correlation analysis showed that severity of inhalation injury was positively correlated with total burn area (r = 0.399, P < 0.001). Among the patients with mild inhalation injury, incidences of patients with mild, moderate, and severe burn of larynx were respectively 68.0% (202/297), 32.0% (95/297), and 0, and those among the patients with moderate inhalation injury were respectively 0,53.7% (58/108), and 46.3% (50/108). There were statistically significant differences in degree of burn of larynx of patients with different degree of inhalation injury (χ2 = 336.703, P < 0.001). Correlation analysis showed that severity of burn of larynx was positively correlated with severity of inhalation injury (r = 0.700, P < 0.001). (2) The rate of tracheotomy was 37.02% (164/443). The rates of tracheotomy in patients with mild, moderate, and severe inhalation injury were respectively 10.44% (31/297), 87.96% (95/108), and 100.00% (38/38), χ2 = 271.654, P < 0.001. Correlation analysis showed that the rate of tracheotomy was positively correlated with severity of inhalation injury (r = 0.784, P < 0.001). Tracheotomy was done mainly within 6 h post burn (63.4%, 104/164). The incidence rate of complication of tracheotomy was 5.5% (9/164). (3) Thirty-one patients died, with a mortality rate of 7.00%. The mortality rates of patients with mild, moderate, and severe inhalation injury were respectively 1.01% (3/297), 12.96% (14/108), and 36.84% (14/38), H = 74.273, P < 0.001. It was found that the mortality was positively correlated with severity of inhalation injury (r = 0.371, P < 0.001). The causes of death of the patients were respectively sepsis (14, 45.2%), respiratory failure (7, 22.6%), airway obstruction (2, 6.5%), airway hemorrhage (2, 6.5%), cerebral hemorrhage (2, 6.5%), cardiac accident (2, 6.5%), and diabetes insipidus (1, 3.2%), and 1 (3.2%) patient quit treatment and discharged from hospital for economic reason.

CONCLUSIONSAmong the patients with inhalation injury, male is dominated in number, and the young adults formed the highest constituent ratio. The severity of inhalation injury was correlated with total burn area, severity of burn of larynx, tracheotomy rate, and mortality. With the guidance of diagnostic criteria of burn of larynx and indication of tracheotomy, the risk of laryngeal obstruction can be eliminated. The early preventive tracheotomy can decrease the difficulty and risk of the operation.

Adolescent ; Adult ; Age Distribution ; Aged ; Airway Obstruction ; etiology ; surgery ; Burn Units ; Burns ; Burns, Inhalation ; complications ; mortality ; surgery ; China ; epidemiology ; Female ; Humans ; Incidence ; Injury Severity Score ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Sepsis ; epidemiology ; Severity of Illness Index ; Sex Distribution ; Tracheotomy ; methods ; Young Adult