ABSTRACT
Objective To explore the effect of quality control circle (QCC) in reducing the health examination report errors. Methods QCC was founded, activity themes were selected, activity schedule was planned, the reasons of health examination report errors were analyzed, goal setting, countermeasures were planned and implemented jointly by circle members. Totally 11 738 reports of health checkup were selected and analyzed the errors were analyzed during the activity, 6 892 were male, 4 846 were female, their average age was(38.01 ± 11.31)years, 5 000 reports were made before improvement, 5 120 reports during improvement, 1 618 reports after improvement and compared the report error rates were compared. Evaluation of QCC activity results and tracking effect were evaluated. Results Error rate of health checkup report from 17.80‰ decreased to 7.23‰ during improvement, dropped to 2.48‰ after improvement. The rate of standard was 141.9%, progress rate was 86.1%. Tracking results for 8 months, error rate remained below the target value of 3.40‰although error rate roise to 5.25‰in August 2016, the effect was good. The additional benefit, working efficiency of the doctors was improved; Average time for each written report was reduced to 4 minutes from 5 minutes;Saved about 1 hours per person a day to review the accuracy of the report and learning; Formed“communication model between clinical departments”;Established the error registration system for the report has been distributed;Similar error of ECG department has been avoided. Conclusions Application of QCC not only reduced the error rate of the health checkup report, but also ensured quality, objective, and accurate physical examination report; activities not merely help to improve the work efficiency of physician, team's mutual cooperation, and is beneficial to optimize the system of medical institution and avoid the error.
ABSTRACT
[Objective]To investigate the pathogenesis,pathology,diagnosis and therapy of hyponatremia after acute spinal cord injury.[Method]Fifteen in-patients with hyponatremia after acute spinal cord injury from 2004 to 2006 were retrospectively analyzed.[Result]Serum sodium was lower than 130 mmol/L in all cases.Urine sodiumcanned was from 40 to 68 mmol/L and urine osmotic pressure was from 420 to 980 mmol/L.After limitation of water intake and appropriate salt intake,12 patients recovered at 2 to 3 weeks.Because of fever and avoiding limitation of water intake,the other 3 patients recovered slowly.[Conclusion]The more serious the acute spinal cord injury,the higher the frequency of hyponatremia;syndrome of inappropriate antidiuretic hormone secretion(SIADH) is its primary cause: appropriate measures should be taken to correct the hyponatremia according to the findings of serum sodium and urine osmotic pressure.
ABSTRACT
Objective To investigate the expressions of erythropoietin(EPO)and its receptor(EPO-R)in the spinal cord after acute traumatic injury in adult rats.Methods Sixty-nine Wistar rats were randomly divided into three groups:normal control group(n=5),spinal cord injury group(n=32),and sham operation group(n= 32).The injury group and sham operation group were further randomly divided into eight subgroups respectively (n=4)(1h,6h,12h,24h,3d,7d,14d,28 dafter operation).The expressions of EPO and EPO-R at different time points were detected by RT-PCR,Western blot and immunohistochemical staining.Results EPO was nut detected at any time point in the normal control grnup,spinal cord injury group or sham operation group.The EPO-R expression was not found in the normal control group or sham operation group.RT-PCR and Western blot analyses revealed EPO-R mRNA and protein expressions in the injury group as early as 6 h after injury.The EPO-R mRNA and protein expressions sharply increased at 12 h,peaked at 24 h to 7 d,and gradually declined after 7 d. They were still higher than those in the control rats 28 d after injury.The EPO-R immunoreactivity was chiefly found in neurons,oligodendrocytes,vascular endothelial and ependymal cells.Conclusion The EPO-R expression can be up-regulated obviously in the injured spinal cord,which provides a molecular basis for the nerooprotection of exogenous EPO.