ABSTRACT
Objective:To explore the effect of the Six Sigma management in reducing the pre-examination and triage error rate of emergency acute abdominal diseases.Methods:Data of 367 misdiagnosed patients in Emergency Department of Shanxi Bethune Hospital from January to June 2018 were collected. Six Sigma management method was applied to the management of emergency acute abdomen triage. After analyzing the causes of errors, improvement measures were formulated and implemented.A total of 118 patients who were triaged from September 2018 to February 2019 were taken as the intervention group to evaluate the effect.Results:After the implementation of Six Sigma management, the errors of acute abdomen diagnosis were significantly reduced from 9.92%(367/3 698) to 2.80%(118/4 219), and there was a significant difference before and after the implementation ( χ2 value was 174.082, P < 0.05). Conclusions:The application of Six Sigma management method can effectively reduce the misdiagnosis rate of emergency acute abdomen triage and realize standardized management of acute abdomen triage, which has the value of popularization and application.
ABSTRACT
OBJECTIVE： To study the difference of the contents of copper， lead， cadmium， mercury and arsenic in the single decoction and combined decoction of Huangqi jianzhong decoction （containing Astragali radix， Cinnamomi ramulus， Paeoniae radix alba， prepared Glycyrrhiza uralensis， Zingiberis rhizoma recens， Jujubae fructus）， and to provide reference for safe use of TCM in clinic. METHODS： Samples of medicinal materials， single decoction and combined decoction were prepared from different medicinal materials； the contents of copper， lead， cadmium， mercury and arsenic in various samples were determined by atomic absorption spectrophotometry， which were compared with the limits of copper （＜20 mg/kg）， lead （＜5 mg/kg）， cadmium （＜0.3 mg/kg）， mercury （＜0.2 mg/kg） and arsenic （＜2 mg/kg） content stated in 2015 edition of Chinese Pharmacopeia and Green Trade Standards of Importing Exporting Medicinal Plants Preparations. The difference of 5 elements contents were compared between single decoction and combined decoction. RESULTS： Among the 6 medicinal materials， the cadmium content of Cinnamomi ramulus and Zingiberis rhizoma recens exceeded the standard， 0.32， 0.74 mg/kg， respectively （copper， lead， mercury and arsenic all met the requirements）， and the 5 elements content of other medicinal materials all met the requirements； the contents of copper， lead， cadmium， mercury and arsenic in the single and combined decoction meet the requirements； compared with the medicinal materials， the contents of copper， lead， cadmium， mercury and arsenic in the single decoction were lower （P＜0.01）； compared with mixture of single decoction， the contents of copper and mercury in combined decoction were lower （P＜0.01）， while the contents of lead， cadmium and arsenic in the decoction were higher （P＜0.01）. CONCLUSIONS： For Huangqi jianzhong decoction， combined decoction can reduce the dissolution of copper and mercury， and increase the dissolution of lead， cadmium and arsenic. The possible reason is that the interaction of various components in the co-decoction process changes the solubility of copper， lead， cadmium， mercury and arsenic.
ABSTRACT
Objective To study the MSCT findings of pulmonary lymphoma,and improve its imaging diagnostic accuracy.Methods The MSCT findings of 14 patients with pathologically proven pulmonary lymphoma were reviewed retrospectively.Evaluated imaging findings included distribution position,number,shape,density and accompanying signs of the lesion.Results In 14 cases of pulmonary lymphoma,except for miliary shadow,there were 108 lesions,including small nodules,nodules,masses,consolidation,ground-glass density and meshlike shadow.Solitary lesions were founded in 2 and multiple lesions were founded in 12 of 14 cases,which the multiple lesions found in single lung in 3 cases,and multiple lesions found in both lungs in 9 cases.There were 24 lesions in 7 cases of pulmonary consolidation, including air bronchogram in 6 cases and bronchiectasis in 3 cases.There were 7 cases with masses,5 cases with nodules,5 cases with small nodules,2 cases with ground-glass density,2 cases with pulmonary interstitial changes,2 cases with CT angiogram sign,4 cases with pleural effusion and 3 cases with mediastinal or pulmonary hilar lymphadenopathy.Conclusion The mainly MSCT findings of pulmonary lymphoma was pulmonary consolidation with air bronchogram,or masses,or nodules,or multiple signs exist at the same time.The diagnosis is mainly based on histopathology.
ABSTRACT
OBJECTIVE:To study the new formula of effective components in TCM for anti-allergic rhinitis (AR),and pro-vide reference for developing TCM preparations for anti-AR. METHODS:Using pseudoephedrine hydrochloride (0-13.5 mg/kg), total alkaloid extracts of Aconitum carmichaelii (0-21.18 mg/kg),volatile oil of asari radix (0-0.0092 mL/kg) in Mahuang Fuzi Xixin decoction as formula objects,uniform design method was used for drug grouping,and multiple regression analysis was con-ducted for the behavioral scores before and after administration,contents of histamine and immunoglobulin E (IgE) in serum of AR guinea pigs to obtain the best formula. Using Xinqin granule,Loratadine tablet,Mahuang Fuzi Xixin decoction respectively as positive control,efficacy of the best formula was verified from aspects of behavioral scores before and after administration,con-tents of histamine and IgE of AR guinea pigs. And the safety of the best formula was preliminarily observed through acute toxicity test in mice. RESULTS:The best formula was as follow as pseudoephedrine hydrochloride 11.25 mg/kg,total alkaloid extracts of A. carmichaelii 21.18 mg/kg,volatile oil of asari radix 0.0045 mL/kg. Compared with each positive drug group,there were no sig-nificant differences in behavioral scores before and after administration in the best formula group(P>0.05). While compared with Xinqin granule group and Mahuang Fuzi Xixin decoction group,histamine content in serum in the best formula group was signifi-cantly reduced (P<0.05);compared with Xinqin granule and Loratadine tablet group,IgE content in serum in the best formula group was significant decreased (P<0.05). Median lethal dose of the best formula was 1822.04 mg/kg. CONCLUSIONS:The screened best formula shows better effect than Xinqin granule and Mahuang Fuzi Xixin decoction in terms of reducing histamine content in serum,better than Loratadine tablet and Xinqin granule in terms of reducing IgE content in serum,with good safety, which indicates the feasibility of TCM effective component formula to a certain degree.
ABSTRACT
OBJECTIVE:To compare the preventive and therapeutic effect of Vinegar testudinis carapax (VTC) water decoc-tion and powder on mice with hemopenia or osteoporosis. METHODS:Mice were randomly divided into normal group (1%CMC-Na),model group (1% CMC-Na),positive group (Compound e-jiao slurry 20 mL/kg or Gusongbao capsule 1.98 g/kg), VTC water decoction and powder low-dose,medium-dose,high-dose groups(1.95,3.90,7.80 g/kg),10 in each group. In hemo-penia mice model experiment,except for the normal group,mice in other groups were intraperitoneally injected cyclophosphamide 0.1 g/kg for modeling,and intragastrically given medicines from the first day(positive drug was Compound e-jiao slurry),once a day,for 8 d. After administration,peripheral blood levels of white blood cells (WBC),red blood cells (RBC),hemoglobin (HG),hematocrit(HCT),platelet(PLT)and bone marrow nucleated cells(BMNC)numbers in femur of mice were determined. In osteoporosis mice model experiment,except for the normal group,mice in other groups were intragastrically given retinoic acid 0.105 g/kg for modeling,and intragastrically given relevant medicines from the first day(positive drug was Gusongbao capsule), once a day,for 30 d. After administration,alkaline phosphatase(ALP)level,organ(thymus,liver,spleen,ovary)coefficients, dry masses and degreasing,ash quality of the femur,and contents of femur calcium and phosphorus in serum of mice were detect-ed. RESULTS:In hemopenia mice model experiment,compared with normal group,WBC,RBC,HG,HCT,PLT levels in pe-ripheral blood and BMNC numbers in femur of mice in model group were decreased (P0.05). Compared with model group,ALP level in serum and dry mass,phosphorus content of femur of mice in VTC water decoction high-dose group were significantly in-creased (P<0.05);ALP level in serum and dry mass,phosphorus content of femur of mice in VTC,powder medium-dose, high-dose group,the ash mass,ash mass/dry mass of degreasing,contents of femur calcium and phosphorus in VTC powder medi-um-dose group were significantly increased(P<0.05). CONCLUSIONS:VTC water decoction shows better preventive and thera-peutic effect on hemopenia mice;while VTC powder shows better preventive and therapeutic effect on osteoporosis mice.
ABSTRACT
Objective To investigate the status quo of oral nursing in the emergency department of top three hospitals in Shanxi province, and to analyze the existing problems so as to provide the basis and reference for improving the clinical operation standard. Methods In the form of WeChat questionnaire, a questionnaire survey was conducted to investigate 190 nurses who met the requirements in emergency departments of 6 top three hospitals in Shanxi province. Results All the 6 hospitals surveyed did not incorporate oral care into the nurse examination program; 28.42％(73/190) of the subjects had oral assessments of endotracheal intubation according to their clinical experience;chlorhexidine (70.00％,133/190) and physiological saline (65.79％,125/190) were the most commonly used oral care solutions in clinic;48.42％(92/190) of nurses performed this operation for 6-10 min;91.58％(114/190) of nurses believed that oral care played an important role in the recovery of these patients. Conclusions The oral care and oral care of the patients in the emergency department are mostly clinical experience, so it is urgent to establish a unified standard of implementation on the basis of evidence. The professional knowledge of oral nursing of the patients undergoing oral trachea intubation is low, so it is suggested that the training of emergency nurses be strengthened and the operation should be included in the assessment of nursing operations.
ABSTRACT
Objective To investigate the anti-rotavirus effect of Gegen Qinlian decoction on rotavirus (RV)-inducing diarrhea neonatal mice model, and provide evidences for pharmacological and pharmacodynamic studies. Methods Neonatal diarrhea mice model of Kunming family infected with RV-Wa was developed. Symptom, diarrhea ratio and severity level, histological changes of neonatal mice’s small intestine and lung was assessed after Gegen Qinlian decoction (0.78 g/kg) treatment. Results Diarrhea ratio, diarrhea severity level, histological changes of neonatal mice’s small intestine and lung were obviously decreased after Gegen Qinlian decoction (0.78 g/kg) treatment. Conclusion Gegen Qinlian decoction has anti-rotavirus effect on RV induced diarrhea.
ABSTRACT
Objectives To evaluate the safety and immunogenicity of Haemophilus influenzae type b capsular-tetanus toxoid(Hib-TT) conjugate vaccine.Methods In an open-controlled,randomized trial,the eligible and consented infants of 3 to 5 months-old received 3 doses of Hib-TT or a licensed Hib-TT conjugate vaccine(Anerbao) as the control vaccine to evaluate safety; The serum anti-Hib PRP IgG antibody mean geometric concentration (GMC) in both groups after primary and boosting vaccination were measured by ELISA.Results No apparent difference in the frequency of total adverse reactions observed between two groups (study vaccine 23.85％ vs.comparator 31.40％) (x2=0.5,P＞0.05).The mild and severe fever reaction of both vaccines was 3.67％ and 4.48％ respectively,with no significant difference.The local reactions including erythema,swelling and induration reported was 1.22％ in study vaccine group.After 3 injections,the serum anti-Hib PRP IgG antibody GMC was 6.6686 μg/ml in study group and 7.5346 μg/ml in control group,with no significant difference in both of the antibody GMC (x2 =0.147,P=0.702).After one dose boosting injection,the serum antibody GMC in study group increased from 2.6396 μg/ml of preboosting to 6.2044 μg/ml of post-boosting.Conclusion The Hib-TT conjugate vaccine is proved to be safe in 3-5 months-old infants.The primary immune schedule for 3-5 months-old infants of 3 injections 1 month apart with the Hib-TT conjugate vaccine could induce IgG antibody response against Hib PRP with the GMC of long-term protection concentration in serum.A boosting dose after primary vaccination elicited obviously immunological memory.
ABSTRACT
Objective To evaluate the immunogenicity of a Haemophilus influenzae type b capsular-tetanus toxoid(Hib-TT) conjugate vaccine produced by Lanzhou Institute of Biological products(LIBP).Methods In an open-controlled,randomized trial,the eligible and consented 6-59 months-old young children injected 2 or 1 times 1 month apart with Hib-TT conjugate vaccine,the 3-5 months-old infants received 3 injections 1 month apart for primary immunization with Hib-TT or a licensed international Hib-TT conjugate vaccine as the control vaccine,and the boosting dose of two 3-5 months-old groups was injected at the 15-17months-old.The serum anti-Hib PRP IgG GMC in both groups after primary and boosting vaccination was measured by ELISA,the percentage of geometric mean concentration (GMC) ≥ 0.15 μg/ml and ≥ 1.0μg/ml was calculated,respectively.Results The Hib-TT conjugate vaccine produced in LIBP elicited satisfactory IgG antibody response in 3-59 months-old young children,the serum IgG GMC of anti-Hib PRP were 14.52 μg/ml(95％ CI:12.31-17.14)in 3-5 months-old,14.04 μg/ml(95％ CI:12.40-15.90) in 6-11 months-old.the ratios of IgG antibody concentration ≥ 1.0 μg/ml were 96.90％ (95％ CI:92.50-99.20) in study vaccine group and 98.55％ (95％ CI:92.20-99.90) in the control vaccine after 3 doses,respectively.100％ of the 6-11 months-old young children who injected 2 times with the Hib-TT conjugate vaccine had IgG antibody concentration ≥ 1.0 μg/ml (95％ CI:95.94-100.00),91.35％ (95％ CI:86.13-99.48) of recipients in 12-59 months-old young children induced the IgG antibody concentration ≥ 1.0 μg/ml after a single dose.The serum IgG antibody GMC in recipients who received the study or and control vaccines increased from 6.27 μg/ml (95 ％ CI:5.28-7.48) and 5.57 μg/ml (95 ％ CI:4.45-6.97)at pre-boosting injections to 63.14 μg/ml(95％ CI:52.14-76.47) and 73.48 μg/ml (95％ CI:57.37-94.11) one month after boosting injection,respectively.The percentage of IgG antibody concentration ≥ 1.0 μg/ml increased from 76.35％ and 79.55％ of pre-boosting to 100％ in the two groups after booting dose.Although the serum IgG GMC in two groups appeared to decline markedly,it remained at a relatively high levels of 25.02 μg/ml (95％ CI:20.51-30.48) in the study vaccine and 23.64 μg/ml (95％ CI:18.40-30.43) in the control vaccine,and all of the recipients in both groups remained 100.0％ of IgG antibody concentration ≥ 1.0 μg/ml.Conclusion The study vaccine elicited a protective immune response and induced the IgG antibody concentration which indicated long-term protection of anti-Hib PRP in 3 to 59months-old infants and young children.
ABSTRACT
<p><b>OBJECTIVE</b>To establish a method to determine the underivatized glycine (Gly) and proline (Pro) in vinegar turtle shell.</p><p><b>METHOD</b>An HPLC-ELSD method was conducted on a Prevail C18 column (4.6 mm x 250 mm, 5 microm) with the mobile phase of acetonitrile and 0.7% trifluoroacetic acid solution (containing 5.0 mmol x L(-1) heptafluorobutyric acid), and elution time was 15 min.</p><p><b>RESULT</b>The calibration curves were showed good linearity within the concentration range of 0.14-0.6 g x L(-1). The average recoveries were 101.2% and 102.5%, and RSD were 1.9% and 2.5%, respectively.</p><p><b>CONCLUSION</b>Since this method needs neither the special amino acid analyzer nor derivation of amino acid., it is efficient, simple and accurate., which could be used for quality control of vinegar turtle shell.</p>
Subject(s)
Animals , Animal Shells , Chemistry , Chromatography, High Pressure Liquid , Glycine , Proline , Quality Control , Reference Standards , Reproducibility of Results , TurtlesABSTRACT
<p><b>OBJECTIVE</b>To investigate the in situ absorption kinetics of berberine (BER) and jatrorrhizine( JAT) at different intestine segments in rats.</p><p><b>METHOD</b>The intestinal perfusion experiment was performed on rats in vivo to observe the effects of absorption sites and drug concentration on the intestinal absorption characteristics of BER and JAT.</p><p><b>RESULT</b>The apparent absorption rate constants (Ka) of BER and JAT at duodenum, jejunum, ileum and colon were 0.1540, 0.1160, 0.9793, 0.6795 h(-1) and 0.0743, 0.0564, 0.0456, 0.0234 h(-1), respectively. The absorption of BER and JAT decreased according to the turn of duodenum, jejunum, ileum and colon. Compared to the lower segment, BER and JAT were better absorbed at the upper and middle segments of intestine in rats. The Ka of BER and JAT had no significant difference when the concentration of the extractive Rhizoma Coptidis was at 22-88 mg x L(-1). However, the absorption quantity of BER and JAT were proportional to the concentration respectively and the saturated phenomena were not observed.</p><p><b>CONCLUSION</b>Both the BER and the JAT is can be absorbed in whole intestine and the results indicated that the absorption of BER and JAT compiled with the first order kinetics through passive diffusion mechanism.</p>
Subject(s)
Animals , Male , Rats , Berberine , Pharmacokinetics , Drugs, Chinese Herbal , Pharmacokinetics , Intestinal Absorption , Intestines , Metabolism , Jejunum , Metabolism , Rats, Wistar , Rhizome , ChemistryABSTRACT
OBJECTIVE:To assay serum berberine in Puerariae and Scutellariae and Coptidis Decoction and coptidis rhi?zoma single decoction in dog and to analyze the effect of the compound recipe(whole recipe)on the physiological disposition of beberine.METHODS:Serum concentrations of berberine in dog were determined at different time by HPLC and the phar?macokinetic parameters were computed with WinNonlin software.RESULTS:The concentration-time curves of berberine in Puerariae and Scutellariae and Coptidis Decoction and coptidis rhizoma single decoction in vivo of dog conformed to one-compartment model,the main pharmacokinetic parameters of berberine in Puerariae and Scutellariae and Coptidis Decoction vs.in coptidis rhizoma single decoction were as follows,AUC (0-∞) (1.25?0.06)vs.(14.71?0.54)(?g?h)/ml,t max (1.92?0.31)vs.(3.03?0.07)h,C max (0.17?0.01)vs.(1.79?0.03)?g/ml.CONCLUSIONS:As compared with single-item recipe,the plasma concentration and bioavailability of berberine in the compound recipe of Puerariae and Scutellariae and Coptidis Decoc?tion were all lower.
ABSTRACT
Object To study the HPCE fingerprinting of Gegen Qinlian Decoction (GQD). Methods A buffer was composed of 30 mmol/L sodium phosphate and 40 mmol/L borate solution. Capillary electrophoresis was performed using a 65 cm (43 cm to detector) ?50 ?m fused-silica capillary tube. Separation voltage was 22 kV, sampling time was 1 s, detected wavelength was 254 nm, and the temperature was maintained at 30 ℃. Results The 27 components in GQD were successfully separated. The observation of methodology was in keeping with quantitatine determination and qualitative study. Conclusion This method can be used for the quality control of the preparation of GQD with good precision.
ABSTRACT
Object To set up the quantitative method for determining the puerarin in Gegen Qinlian Decoction (GQD) by RP-HPLC and to study the change of puerarin contents in various combinations of GQD. Methods L 8(2 7) orthogonal design and statistic analysis (SPSS 10.0) were used, the puerarin contents in the samples were determined by HPLC. Results Influence of Radix Scutellaria, Rhizoma Coptidis and Radix Glycyrrhizae Preparata on the puerarin content in GQD was insignificant. And interactions between two of three were insignificant too. In this experiment, puperarin in the sedimentation was found in the compatible decoction of Rhizoma Coptidis and Radix Puerariae. Conclusion The puerarin content is not markedly influenced by Radix Scutellaria, Rhizoma Coptidis and Radix Glycyrrhizae Preparata. Maybe, the change of pH is relevant to the sedimentation in the compatible decoction contained Rhizoma Coptidis. and Radix Puerariae
ABSTRACT
Object To set up the quantitative method of baicalin in Gegen Qinlian Decoction (GQD) by RP HPLC and to determine the change of baicalin contents in decoctions prepared from various combinations of GQD. Methods By L 8(2 7) orthogonal design and statistics analysis (SPSS10 0), eight decoctions with Radix Scutellariae either alone or incombination with one or more of the other three components were prepared or analyzed. Contents of baicalin in them were determined by RP HPLC. Results It was significant (P0 05) and interactions between two of three were insignificant either. In this experiment, the sedimentation was found in the decoctions contained Radix Scutellariae and Rhizoma Coptidis. Conclusion The content of baicalin is reduced by Radix Puerariae and Rhizoma Coptidis, The resolution of baicalin is not increased by Radix Glycyrrhizae Preparata. Maybe the change of pH leads to the sedimentation in decoctions contained Radix Scutellariae and Rhizoma Coptidis.
ABSTRACT
Objective To discuss the selection of indication for using uterine artery perfusion and embolization in tubal pregnancy. Methods Fifty one cases of tubal pregnancy were treated by superselective trans-uterine artery (TUA) catheterization with perfusing Methorexate (MTX) and then embolized the uterine arteries by gelfoam. The comparisons among serum P-HCG concentration, abdominal bleeding and the size of the ectopic mass could state the importance of the indication selection preprocedurally. Results Forty eight of the 51 cases were cured by this method, when the ectopic mass size≥5 cm, the cure rate was low, 33.33% (P