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Objective:To summarize the relevant evidence for the management of fixation in traumatic spinal cord injury patients, which provides a reference for the clinical care and care of patients.Methods:A systematic search was conducted for evidence related to spinal injuries from domestic and foreign databases, relevant guideline websites, etc. The types of literature were best practice, expert consensus, systematic review, evidence summary, clinical decision-making, etc. The search time was from the establishment of databases to January 31, 2022. Three researchers used the Multidimensional Systematic Review Tool to evaluate systematic review literature. Five researchers used the guideline research and evaluation tool AGREE Ⅱ to evaluate clinical practice guidelines, and used the Australian JBI Evidence-Based Health Care Center (2016) to evaluate expert consensus and expert opinion with the authenticity evaluation tool for expert opinions and professional consensus articles. And extracted and summarized evidence according to the subject.Results:Finally, 10 articles were included, including 4 clinical decision-making, 4 guidelines and 2 systematic evaluations. The 30 pieces of evidence include the assessment, prevention, cervical spinal fixation, and management after traumatic spinal cord injury.Conclusions:The evidence emphasizes the importance of standardized assessment of cervical risk factors in all emergency adult patients with traumatic spinal cord injury. In the emergency department, we need to improve the ability of spinal evaluation and fixation in patients with penetrating neck injury, optimize the timeliness process of emergency trauma, reduce the occurrence of potential complications, and improve patient outcomes.
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Objective To explore the effect of improving the process of intravenous therapy using six Sigma methodology among hospitalized patients. Methods Select patients of a certain ward in our hospital as the objects. Used the steps of standard six Sigma methodology as define, measure, analyze, improve, and control. Analyze the relevant causes and formulate improvement measures after identifying and defining the adverse events. Quality control team ensured the implementation of the improvement measures, and finally compared the incidences of adverse events before and after the implementation of the measures. Results Before implementation of the improvement measures, intravenous therapy was performed within 1056 persons in a month. There were 132 adverse events, and the percentage was 12.5％. After the implementation of improvement measures, 1102 patients were performed intravenous therapy. There were 81 adverse events, and the percentage was 7.4％. The incidence of adverse events was significantly reduced (χ2=16.08, P<0.01). Conclusion The application of six Sigma management method can effectively improve the effect of intravenous treatment of inpatients with reducing the incidence of adverse events.
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Objective To establish a method for the determination of 17 kinds of free amino acid in serum by the ultra perform-ance liquid chromatography(UPLC) with AQC pre-column derivatization .Methods After proteins precipitation in serum sample by acetonitrile ,free amino acids with aminoquinoline-N-butyl hydroxy diimide and carbamate(AQC) were reacted to generate the struc-tural stable derivative products with ultraviolet absorption .These products were separated by reversed-phase C18 column ,detected with UV detector and quantitated by the external standard .Results The within-run precision of 17 kinds of free amino acid was 2 . 81% -7 .35% and the between-run precision was 7 .44% -15 .40% .The linear relationship was good in the range of 2 .5-250μmol/L ,the linear correlation coefficient was 0 .9960 -1 .0000 ,RSD<3% .Conclusion Using this method for determining 17 kinds of amino acid in serum ,the complete separation is obtained within 10 min ,the results are accurate ,stable and highly efficient .
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Objective To explore the value of glypican-3(GPC-3)mRNA and paternally expressed 10(PEG10)mRNA in peripheral blood in diagnosis of metastasis in hepatocellular carcinoma(HCC). Methods With SYBR Green I as fluorescence signal,real-time fluorescent quantitative reverse transcription-polymerase chain reaction was employed to detect the expression of GPC-3 mRNA and PEG10 mRNA in peripheral blood from patients with HCC with metastasis(n=8),HCC without metastasis(n=12)and hepatic cirrhosis(n=11),and receiver operator characteristics curve(ROC)and specific parameters were adopted to analyse their value in predictive and exclusive diagnosis. Results The expression of GPC-3 mRNA and PEG10 mRNA in HCC with metastasis was significantly higher than that in HCC without metastasis and in hepatic cirrhosis(P<0.05),while there was no significant difference in the expression of GPC-3 mRNA and PEG10 mRNA between HCC without metastasis and hepatic cirrhosis.In single test,the sensitivities in the differential diagnosis between HCC with metastasis and HCC without metastasis were 66.7%for GPC-3 mRNA and 72.2%for PEG10 mRNA,and the specificities were 91.7%and 91.7%.respectively.The areas under ROC were 0.748 for GPC-3 mRNA and 0.812 for PEG10 mRNA.With two markers in parallel test,the sensitivity,specificity,negative likelihood and diagnostic accuracy were 90.7%,84.O%,0.11 and 83.3%,respectively.In serial test,the sensitivity,specificity,positive likelihood and diagnostic accuracy were 60.5%,98.7%,45.5 and 73.3%,respectively. Conclusion Detection of GPC-3 mRNA and PEG10 mRNA in peripheral blood may help to predict blood metastasis and extrahepatic metastasis of HCC,and PEG10 mRNA works better than GPC-3 mRNA.The serial test of GPC-3 mRNA and PEG10 mRNA is helpful to the predictive diagnosis of peripheral blood metastasis of HCC.
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Objective To investigate the red blood cell in urine after kidney puncture and know the best detection method.Methods Collected three urines of 31 patients after kidney puncture and detected the red blood cell by UF-100 and the hemoglobin by urine dipstick test.At the same time,detect the conductivity of the urine by UF-100.Results Both the UF-100 and urine dipstick test could reflect the decrease of red blood cell after kidney puncture.But both of them had some limits.Sometimes the results of the two method were not relative(κ=0.148).The agreement of two methods was 0.538.Neither of them could reflect the bleeding of the kidney accuracy.Conclusion By the best,we should use both the UF-100 and the urine dipstick test to detect the red blood cell in urine after kidney puncture,at the same time we should consider the conductivity of the UF-100.
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Objective To observe the oculocardiac reflex during the ocular plasty and to study its possible mechanism. Methods A total of 132 cases were studied by dynamic electrocardiography to analyze the changing of heart rate before and after operations. Results Heart rate decreasing by over 10 times during operations was regarded as the positive standard of the oculocardiac reflex. Of all cases the oculocardiac reflex appeared in 41 cases and 53 times were observed including of continual two times happened in 6 cases. In all the reflex ,9 cases was observed in injection of anaesthetic, 5 cases in pulling eyelids, the orbicular muscle and the palpabralis muscle, 21 cases in resecting orbital fats,6 cases in stressing the eyeball after operations. The incidence of oculocardiac reflex was 31.1%. Conclusion Some steps in the process in ocular plasty are more possible to elicit the reflex, such as dragging peripheral eyeball muscles,stressing eyeball and pulling eyelid. The reflex will result in heart rate decreasing, heart rhythm and respiratory changing,even render heart to sudden stop . Therefore, we should operate gentlely and accurately,and also avoid overly stress on eyeball to elicit the oculocardiac reflex.
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ObjectiveTo summarize the clinical characteristics of pt osis,one of complications after double eyelid blepharoplasty, and to explore i ts causes and attempt for the resolutions. MethodsThe clinica l symptoms were divided into three types based on the degrees of the ptosis afte r double eyelid blepharoplasty. The causations in 25 cases of different degree o f ptosis after double eyelid blepharoplasty were investigated and analyzed durin g operations. The local adhesive deformities were analyzed so as to take differe nt resolutions for the complication. Results It seemed that th e operative damage to the aponeurosis was the main reason for the complication. So it caused the scar adhesive deformities between the palpabralis aponeurosis a nd the orbital membrane or the skin of upper eyelid, resulting in the difficult y of the palpabralis muscle's contract and unablility of the muscle function in different degrees. Conclusion The ptosis can surely be av oided if we have good knowledge about the mechanism of double fold formation and the anatomy of eyelids and perform the operation meticulously.
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Objective To establish the immunoprecipitation method to detect the activity of ?-glutamyltransferase (GGT) complexed to low-density-lipoprotein and very-low-density-lipoprotein in serum (LDL-LDL-GGT) and to observe the diagnostic efficiency in discriminating liver malignancies from other hepatopathy diseases.Methods Using apo B antibody as a precipitant to precipitate the parts of GGT which connected to LDL and VLDL. 65 cases of liver malignancies, 53 cases of cirrhosis, 32 of chronic hepatitis and 75 of health people were analysed. Results Apo B antibody can precipitate LDL and VLDL thoroughly with various serum samples. The withinrun CV are 3 6%～8 2% and the betweenrun CV are 5 5%～9 8%. The linearity range is 0～587 U/L. With the cut off value of 10 U/L, the sensitivity for liver malignancies is 86 2%, the specificities for discriminating liver malignancies from cirrhosis and chronic hepatitis is 67 9% and 81 3% respectively. Conclusion It has important significance for the diagnosis of liver malignancies with the immunoprecipitation method for determination of serum LDL-VLDL-GGT activity.
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Objective:To clone the full-length cDNA of human ubiquitious mitochondrial creatine kinase(uMtCK) and express its protien in E. coli. The protein was used to immunize rabbit to prepare anti-uMTCR polyclonal antibody which was then used to detect the expression of uMtck in gastrointestinal carcinoma. Methods: A 1 062 bp segement was amplified from human HaLa cell by RT-PCR,which was then inserted into pMD18-T plasmid and proved to be the coding sequence of uMtCK by endonuclease digestion and sequencing. The coding sequence of uMtCK was inserted into pQE30 plasmid and recombinant plasmid pQE30-uMtCK was transformed into E. coli. The expressed protein was purified with a His. Bind column and was analyzed with SDS-PAGE and Westen blot and the activity of uMtCK was tested. An antiserum against uMtCK was perpetrated by immunizing rabbit with purified uMtCK. The expression of uMtCK in 59 patients with gastric and colonic cancer was detected by immunohistochemistry. Results:The coding sequence of uMtCK was successfully obtained by RT-PCR and the product was successfully inserted into pQE30 to construct a recombinant vector pQE30-uMtCK. The expression of uMtCK was effective and soluble, A good specific antiserum against uMtCK was proved by Western blot. The expression of uMtCK of gastric and colonic cancer was 76. 5%. Conclusion:The coding sequence of uMtCK is coined and expressed in E.coli. uMtCK is a prospective marker for the diagnosis of gastric and colonic cancer.