Root cause analysis as used in China's hospital management: current research and application / 中华医院管理杂志

Objective To review the current research and application of root cause analysis (RCA) method in China's hospital management.Methods A retrospective analysis in six aspects was made by means of formulating a retrieval strategy and inclusion criteria, retrieval of databases, and literature review.Results The number of Chinese RCA researches was increasing year by year, mostly from researcher of the eastern coastal areas.These studies focused on the effects of RCA application outcomes and nursing safety.Tools in use were mainly fishbone diagram, brainstorming and 3-why method.72.24% of the root causes as found in literature were system factors, and 27.76% were human factors.Most of the researches made positive comments on RCA.Conclusions RCA is being warmly embraced by China's hospital management as it can positively change the accountability culture towards adverse events.Yet RCA has not been satisfactorily applied, and its future research and application in China's hospital management need more in-depth study and critical analysis.

Discovery of novel protein biomarkers in early silicosis by proteomics and identification of alpha B-crystallin / 中南大学学报(医学版)

OBJECTIVE@#To establish 2-dimensional gel electrophoresis (2-DE) image for the early lung injury rats induced by silica dioxide and to identify differentially expressed protein biomarkers during the early stage of silicosis.
@*METHODS@#The animal models of silicosis were established and morphology changes were observed by HE staining, and then the key protein biomarkers in silicosis were identified by 2-DE and matrix-assisted laser desorption/ionization time of flight tandem mass spectrometry (MALDI-TOF-MS) and verified by Western blot.
@*RESULTS@#The well qualified 2-DE gel images for experimental and control lung tissues were successfully established, and 40 different protein spots was observed when comparing the gel images between the experimental and control groups. Twenty of them were analyzed by MALDI-TOF-MS. A total of 13 altered proteins were identified, including alpha B-crystallin, mast cell protease 6, annexin 1, etc. The expression of alpha B-crystallin in lung was further verified by Western blot.
@*CONCLUSION@#The protein expression of alpha B-crystallin was increased significantly, suggesting that it might play an important role in the progress of silicosis.

Practice and reflection on enhancing clinical pathology general education in clinical medicine graduates / 中华医学教育探索杂志

Because of ignoring the basic knowledge training, the medicine graduates lack ba-sic knowledge of clinical pathology, which has seriously affected their improvement of medical skills. The paper analyzes the status of pathology teaching in clinical medicine graduates and the necessity to strengthen clinical pathology general education. Then it proposes measures about enhancing clinical pathology general education, so as to increase the basic clinical pathology knowledge of medical grad-uates.

Clinical and pathological analysis of prostate cancer with low level of serum prostate specific antigen: a report of 4 elderly cases and literatures review / 中华老年医学杂志

Objective To investigate the clinical and pathological features of prostate cancer with low level of serum prostate-specific antigen (PSA) in elderly patients.Methods Data of 328 patients with prostate cancer were retrospectively analyzed.Clinical and pathological data of 4 prostate cancer patients with low serum PSA level were analyzed.Potential risk factors and diagnostic methods of prostate cancer with low serum PSA level were discussed based on the clinical data combined with literatures.Results Mean age of the 4 patients was 71.3 years.Mean PSA value on admission was 1.96 μg/L.2 patients had abnormal digital anal examination results.2 patients were pathologically diagnosed as adenocarcinoma after puncture,among which 1 had duct adenocarcinoma,and the other 2 patients were pathologically diagnosed as neuroendocrine carcinoma after puncture.2 patients with neuroendocrine carcinoma of prostate were treated with endocrine therapy,and the other 2 patients were treated with radical prostatectomy plus auxiliary endocrine therapy.Conclusions Prostate cancer with low serum PSA level has an insidious onset,which is prone to miss the diagnosis.It should be paid sufficient attention for the diagnosis,and monitoring of prostate cancer is independent on PSA.Prostate cancer with low serum PSA level should be diagnosed in combination with some basic examinations such as serum free prostate specific antigen,prostate specific antigen density and digital rectal examination,et al.

Expression of Calponin-1 and Transgelin in human uterine smooth muscles in non-labor and labor situation / 中南大学学报(医学版)

OBJECTIVE@#To investigate the expression of Calponin-1 and Transgenlin in the uterine smooth muscles during normal labor on-sets, and to evaluate their effect on initiating the normal labor.@*METHODS@#A total of 14 uterine bodies and lower segments of human pregnancy were divided to a non-labor group (NIL) and a labor group(IL). Immunohistochemical technology and Western blot were used to determine the expression of Calponin-1 and Transgelin in the 2 groups.@*RESULTS@#Immunohistochemical detection and Western blot showed that Calponin-1 protein in the uterine smooth muscle tissue of the body and the lower uterine segment of smooth muscle tissues had significant difference (P0.05).@*CONCLUSION@#Calponin-1 of the uterine smooth muscle and Transgelin of the uterine body smooth muscle may involve in the regulation of uterine smooth muscle contractility, which is closely related to child birth launch.

Construction of adenoviral vector encoding Calponin-1 siRNA and its effect on human myometrium cells in vitro / 中南大学学报(医学版)

Objective To investigate the effect of Calponin-1 suppression on human myometrium cells through adenovirus mediated siRNA. Methods Human uterine smooth muscle tissues were digested with enzymes, cultured and confirmed with immunocytochemistry. Aadenovirus siRNA-Calponin-1 plasmid was transfected into primary cultured uterine smooth muscle cells in vitro. The expressions of Calponin-1 mRNA and protein were analyzed by RT-PCR and Western blot, respectively.Results The pAdEasy-pShuttle-U6-Calponin-1 siRNA plasmid was successfully constructed, and Calponin-1 siRNA mediated by recombinant adenovirus resulted in markedly reduced expression of Calponin-1 mRNA and protein in human myometrium cells. The gray values of Calponin-1 mRNA in the uterine smooth muscle cells in the experimental, blank control, and empty vector groups were 316.3±39.2, 1048.5±126.4 and 1027.2±127.5, respectively. The gray values of Calponin-1 protein were 323.3±43.2, 1021.5±143.4, and 1019.2±144.5,respectively. The difference between the experimental group and the blank control group as well as the empty vector group was significant (P< 0.05). There was no significant difference between the empty vector group and the blank control group (P>0.05).Conclusion The pAdEasy-pShuttle-U6-Calponin-1 siRNA plasmid can inhibit the expression of Calponin-1 in human myometrium cells in vitro,which may be a useful approach to determine the role of Calponin-1 in delivery.

Videomorphometric Analysis of Tthyroid Follicular Tumor / 中国医师杂志

Objective To explore the significance and practical value of videomorphometric analysis in differential diagnosis of the thyroid gland in benign and malignant follicular lesions. Methods A videomorphometric analysis of surgically resected thyroid follicular tumors and normal thyroid gland was respectively performed with CMM-3 image analysis system. 50-100 tumor cell nuclei each case were studied at random for their area, perimeter, average diameter, shape factor and atypical index.Results Hightly significant statistical difference was observed in every parameter between normal and malignant, benign and malignant cases.Conclusion It is suggested that videomorphometry is an useful tool for the differential diagnosis of benign from malignant tumors of thyroid gland.

Expression of Cytokeratin 19 in Different Live Tissues From Victims With Third-degree Burns in Repair Process / 中国医师杂志

Objective To study the expression characteristics of cytokeratin 19(CK19) in different live tissues from victims with third-degree burns to explore the possible mechanisms of tissue reparation and regeneration in orthophoria.Methods 10 young victims with third-degree burns were included in this study.Alive tissues at different regeneration stages were studied by immunohistochemistry with streptavidin-biotin-peroxidase method using specific anti-CK19 monoclonal antibody. Only cytoplasm expression was considered as specific.Normal skin tissue and chronic skin ulcer were used as controls.The study was focused on the distribution and morphological features of CK19-positive cells.Results ⑴In normal skin ,CK19-positive cells were seen in basialis layer of epiderm and cutaneous appendages.⑵CK19-positive cells were not found in subcutaneous tissue at 3～6 days after the injury,but they were seen in granulation tissues.⑶A lot of CK19-positive cells were detected in early regeneration tissues.⑷In late regeneration tissues,CK19-positive cells were detected in basialis layer of epiderm and cutaneous appendages.⑸Advanced regenerationed epidermal tissue was similar to that of normal.⑹No CK19-positive cells were observed in all of 6 cases with chronic skin ulcer.Conclusion It is possible that victims with third-degree burns could be healed by tissue regeneration orthophoria.