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Objective:To study the effects of cold spray on pain after non-coring needle insertion.Methods:This was a randomized controlled study. Patients with totally implantable access port (TIAP) were randomly divided into the experimental group and the control group. The experimental group were given cold spray, while the control group were given eutectic mixture of local anesthetics cream (EMLA). The severity of pain, comfort and satisfaction, right-first-time insertion rate and skin reaction incidence were compared between groups.Results:29 patients were included in each of the two groups. The pain assessed with numeric rating scale in the experimental group was less severe than the control group ([1.52±1.02] vs [2.24±1.62]). However, there was no significant difference (d=-0.02 [95% CI:-0.55~0.51], P=0.109). The right-first-time insertion rate was 100% for both groups. The incidence of skin reactions in experimental group was lower (ARR=27.6% [95% CI: 11.32%~43.86%], P=0.008), and comfort scores ( d=-0.97 [95% CI: -0.42~-1.52], P<0.01) and satisfaction scores(ARR=13.8% [95% CI: 1.24%~26.34%], P=0.013) were significantly higher compared with control group. Conclusions:There was no statistically significant difference in the analgesic effect of cold spray and EMLA on pain from non-coring needle insertion. Cold spray acted quickly, comfortably and safely, resulting in better patient satisfaction.
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Peripherally inserted central venous catheter (PICC)-related upper extremity venous thrombosis (UEVT) is defined as upper extremity venous thrombosis within the veins where PICCs were placed or adjacent to and may result in pulmonary embolism. Malignancies, previous history of venous thrombosis and malposition are common risk factors for PICC-UEVT. Once patients demonstrate clinical manifestations of phlebitis and thrombosis, such as swelling, pain and tenderness at the PICC site, venous duplex ultrasonography is the first choice for diagnosing PICC-UEVT. According to American College of Chest Physicians guidelines, it's not recommended to remove PICCs upon detection of PICC-UEVT. The first-line treatment is to administer systemic anticoagulants while keeping the catheter in place, unless any contraindications. PICCs could continue to be used during anticoagulation therapy, suppose that catheter tip remains well placed and functions as normal. With early diagnosis and standard anticoagulant treatment, a better clinical outcome could be achieved. Prophylactic anticoagulation is not routinely recommended per guidelines. Recommendation for asymptomatic PICC-related thrombosis is still absent and warrants further prospective studies with large sample size.
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Objective:To establish a supportive and effective management mode of scientific research project application, promote the capacity building of scientific research in the hospital.Methods:Retrospective analysis was conducted on the national and provincial scientific research projects of Xinhua Hospital Affiliated to Shanghai Jiaotong University Medical School from 2010 to 2019, and the practical effect of " point to point" management mode of scientific research project application was evaluated.Results:The funding rate of Xinhua Hospital, especially national scientific research projects and provincial talents projects, was greatly improved by adoption of the multi-dimensional " point to point" management mode of scientific research project application. The number of national scientific research projects increased from 34 (26.02 million) in 2010 to 72 (51.0851 million) in 2019.The number of provincial talents projects increased from 5 (1.05 million) in 2010 to 26 (6.5 million) in 2019.Conclusions:The " point to point" management mode of scientific research project application plays an important role in promoting the overall funding rate. Enhancement of comprehensive capacity of hospital scientific research can be achieved by further improvement of this management mode, early initiation and arrangement of funding application depending on the " close partner" entity, emphasizing scientific research talents cultivation.
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Objective:To explore the application effect of time-sharing appointment in the peripherally inserted central catheter(PICC) maintenance clinic.Methods:Patients with medical appointments within two months before and after the application of time-sharing appointment practice in the PICC maintenance clinic were selected. Patients with appointment before application were control group and took paper appointment sheet manually while those after application were study group and took time-sharing appointment. Waiting time, average number of patients waiting per pre-specified time period, patient satisfaction and nurse satisfaction were compared between the two groups.Results:The median waiting time of the study group was 15 min, significantly shorter than that of the control group of 46 min ( P<0.01). The numbers of patients waiting in the waiting area for the study group remained relatively stable across each time period, showing low people density. In the contrast, numbers of patients waiting varied significantly for the control group and the peak of patient flow occurred in periods of 8∶00—10∶00 and 13∶30—14∶30. Patient satisfaction and nurse satisfaction of the study group were both significantly higher than those of the control group (4.99±0.05 vs. 2.15±0.17, P=0.009; 4.67±1.92 vs. 1.90±0.37, P<0.01, respectively). Conclusion:The application of time-sharing appointment in PICC maintenance clinics effectively reduces the waiting time for patients, achieves reasonable patient triage, improves the clinic environment, improves nurse and patient satisfaction, and improves the level of hospital management.
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Objective:To investigate the associations between serum uric acid levels during the third trimester of pregnancy and risks of adverse pregnancy outcomes.Methods:In this retrospective study, a cohort of 7 995 pregnant women who were hospitalized for childbirth from January 2014 to January 2019 were collected to compare pregnancy outcomes between subjects with or without hyperuricemia (HUA). A smooth curve analysis was used to evaluate the relationship between uric acid levels and preterm delivery, low birth weight and smaller than gestational age. Logistic regression analyses were performed to identify risk factors for adverse pregnancy outcomes, and the interaction of the factors.Results:During the third trimester of pregnancy, the uric acid levels of about 10% pregnant women were over 420 μmol/L. In those with HUA, the median neonatal birth weight was 2 590 (1 790, 3 410) g, the probability of premature birth was 49.81%, and the incidence of small than gestational age was 20.41%. These were significantly different from the women without HUA (the median neonatal birth weight: 3300 (2850, 3640) g; the probability of premature birth 23.09%; the incidence of small than gestational age 6.55%, respectively) (All P<0.001). Maternal uric acid levels were negatively correlated with neonatal birth weight, and positively correlated with the risk of smaller than gestational age. It has a U-shaped association with the probability of premature birth, and the lowest probability of premature birth was at 200-400 μmol/L of the uric acid. Risks of low birth weight (adjusted β=-5.22, 95% CI-6.46—-3.99) and smaller than gestational age (adjusted OR=1.03, 95% CI 1.02-1.04) were increased in the function of uric acid levels. High uric acid, hypertension, oligoamnios and preeclampsia were important risk factors for the adverse pregnancy outcomes. The risk of preterm delivery and low birth weight enhanced when hyperuricemia combined with hypertension and preeclampsia. Conclusions:Serum uric acid level can be used as one of reliable markers for predicting adverse pregnancy outcomes, which might provide theoretical basis for clinical intervention in practice.
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Objective:To investigate nurses' knowledge, attitude and behavior status about the safety management of enteral nutrition tube in a tertiary Class A hospital in Beijing.Methods:A self-designed questionnaire based on reliability and validity was used. Besides, a convenient sampling method was used to select 309 nurses working on enteral nutrition from the hospital.Results:Nurses scored (28.58±6.09)for knowledge, (37.65±5.03)for attitude and (70.01±5.45)for behavior. The percentage of average scores in the three indicators were 57.16%, 94.13% and 93.35%. According to the single factor analysis, the score of behavior differed among nurses with different working years( F=23.61, P=0.032). The score of knowledge differed among nurses with different titles( F=4.48, P=0.012). Besides, the frequency of tube feeding operations had great effects on nurses′ knowledge and behavior ( F=9.64, P<0.001; F=34.59, P=0.018). But there was no statistical difference in the knowledge, attitude, and behavior scores among nurses trained at different frequencies( F=0.85, P=0.497; F=12.56, P=0.231; F=18.97, P=3.479). Conclusions:Nurses have a positive attitude towards the safety management of enteral nutrition tube, but their knowledge level is poor and their behavior needs to be further regulated. It is necessary to carry out relevant training to standardize clinical operations and ensure the safety management of enteral feeding tube.
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Objective To establish a simple animal model of cough variant asthma(CVA)through sensitizing Brown-Norway(BN)rats with ovalbumin(OVA). Methods A total of 36 BN rats were randomly divided into three groups, including the normal control group,the model control group and the montelukast group. BN rats in the model group and the montelukast group were intraperitoneally administered with 2.0 mg of OVA and 100 mg of Al(OH)3,and the same volume of sterile saline was given to the normal group by intraperitoneal injection. Boosting was carried out by intraperitoneal administration with 0.01 mg of OVA and 100 mg of Al(OH)33 weeks later,and the rats in the normal group were injected with the same dose of physiological saline. Three weeks later,the actively sensitized BN rats were challenged with aerosolized OVA for 7 times on alternative days,and the rats in the normal group were treated with sterile saline instead of OVA. At the same time, the montelukast group was given 1.3 mg/kg of montelukast 30 minutes before atomization by intragastric administration once a day for 2 weeks,and the normal group and the model group were given the same volume of water. The tests of cough sensitivity to capsaicin and bronchial responsiveness were performed 24 h after the last administration. Results Compared with the normal group, the times of coughing(P< 0.01)and the lung resistance(RL)(P< 0.05)in the model group were significantly increased,while the lung compliance(Cdyn)was significantly decreased(P< 0.05). There was a significant difference(P < 0.05)in the times of coughing caused by capsaicin between the model group and the montelukast group. Compared with the model group,RLin the montelukast group was decreased significantly(P< 0.05), and Cdynwas increased significantly(P< 0.05). Conclusions This rat model of CVA is similar to a variety of clinical features of CVA and is easy to operate. Thus it can be used as an effective animal model of CVA.
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Objective To provide practical suggestions for nurse management by exploring the influence of work family conflict on the nurses′emotional labor and its boundary condition. Methods A six months′time lagged longitudinal research design was employed. A total of 233 nurses from two state-owned hospitals were recruited for this study to complete a questionnaire including Work-Family Conflict Scale, Perceived Organizational Support Scale and Emotional Labor Scale. Results Data analysis showed that the score of work family conflict was (2.86 ±1.31) points, the score of perceived organizational support was (5.28 ± 1.12) points, the score of surface emotional labor and deep level emotional labor was (5.31 ± 1.08) points and (3.64 ± 1.45) points, respectively. The work family conflict was negatively correlated with deep level emotional labor (r=-0.27, P<0.01), but was positively correlated with surface emotional labor (r=0.23, P < 0.01). The perceived organizational support was positively correlated with deep level emotional labor (r=0.22, P < 0.01), but was insignificantly correlated with surface emotional labor (r=0.12, P>0.05). The regression analysis revealed that work family conflict was positively related to surface emotional labor (β=0.22, P<0.01), and is negatively related to deep level emotional labor (β=-0.22, P<0.01). Perceived organizational support moderates the effect of work family conflict on emotional labor (β=-0.22, P<0.01;β=0.18, P<0.05, respectively). Conclusions This study indicates that work family conflict has the potential in enhancing surface emotional labor and decreasing deep level emotional labor. Perceived organizational support helps to weaken the negative effect of work family conflict on deep level emotional labor and the positive effect of work family conflict on surface emotional labor.
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Objective: To research the anti-inflammatory and anti-allergic effects of Qifangbimin particle.Methods: The anti-inflammatory effects were observed by the methods of xylene-induced ear-swelling in mice and cotton-ball induced granuloma in rats.The anti-allergic effects were evaluated by the method of passive skin allergy model in rats and ear-heterogeneous passive skin allergy model in mice.Results: In the treatment groups with Qifangbimin particle, the swelling degree of ear edema induced by dimethylbenzene in mice was significantly suppressed when compared with that in the control groups (P<0.01 or 0.05) , however, the particle had no significantly inhibitory effect on granulation tissue hyperplasia induced by cotton-ball in rats.The Qifangbimin particle groups obviously decreased the absorbance value of locus coeruleus on rats' back (P<0.01 or 0.05), and Qifangbimin particle at high dose significantly reduced the absorbance value of locus coeruleus of auricle in mice (P<0.01 or 0.05).Conclusion: Qifangbimin particle has significant anti-inflammatory and anti-allergic effects.
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Objective To observe the effect of the application of peripherally inserted central catheter (PICC) network platform in the information management of the patients with PICC.Methods Altogether 17 254 outpatients receiving PICC maintenance in Peking Union Medical College Hospital from April 2012 to April 2013 were enrolled as the control group,including 7 227 males and 10 027 females,with the median age of 58 years (12-85 years).A total of 20 384 outpatients from April 2013 to April 2014 with PICC were selected as the observation group,including 8 188 males and 12 196 females,~th the median age of 59 years (13-86 years).Those patients all received PICC maintenance in outpatient clinic during the intermission of therapy after PICC insertion.The time of data entry,the integrity of the data,description accuracy about complications,and normalization of wording were compared between the two groups.Results The average time of data entry in the control group was (46 ± 6) seconds,significantly longer than that in the observation group [(12 ± 5) seconds,t =562.660,P ＜ 0.05].In terms of the integrity of the data,there were 11 732 cases of complete data,3 623 cases of less complete data,and 1 899 cases of incomplete data in the control group;while the numbers of cases of complete data,less complete data,and incomplete data in the observation group were 19 568,725,and 91,respectively,showing significant difference compared with the control group (x2 =5 312.000,P ＜ 0.05).In the description accuracy about complications,the control group had 11 840 accurately described cases and 5 414 inaccurately described cases,while the observation group had 18 427 accurately described cases and 1 957 inaccurately described cases (x2 =2 814.000,P ＜ 0.05).The wording was standard in 15 280 cases but not standard in 1 974 cases in the control group,and standard in 19 659 cases and not standard in 725 cases in the observation group,with significant inter-group difference (x2 =872.600,P ＜0.05).Conclusion Simple and convenient data summary could help quality control and quality analysis,preferably guarantee the safety of catheter insertion and reduce the incidence of complications.
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S100 A7 is a small calcium-binding protein that has an important role to play in the differentiation of human kerati -nocytes.It also helps build the chemical defense system of the skin and responds to oxidative stress and inflammation .The expression of S100 A7 can be induced by physical , chemical and biological stimulations .S100 A7 has many ligands and is related to the reactive oxygen species (ROS) via specific signaling pathways.As an important antimicrobial peptide, S100A7 helps the skin fight against main pathogens .S100 A7 is also a key indicator for the state of inflammation and cell differentiation;and its up-regulation has been cor-roborated in various skin diseases .In the brain of patients with Alzheimer′s disease, the up-regulation of S100A7 in primary cortico-hippocampal neurons can inhibit the generation of β-amyloid peptides .Moreover , S100 A7 is also up-regulated in different types of cancer and closely related to tumor malignancy and progression .In this review, we introduce biological properties of S 100A7 and high-light its expression characteristic in related diseases .This should have implication for the discovery of potential biomarkers and targets for the treatment of S100A7-related diseases.
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Aconite roots are a common clinical poisonous herb in Chinese herb. It has the effect of restoring yang and rescuing collapse, supplementing fire and assisting yang, eliminating cold and relieving pain. It is used in the treatment of yang collapse and yang deficiency syndromes. It is called principle medicine of all medicines. Monks-hood polysaccharide is one of effective components in Aconite roots. The study found that monkshood polysaccharide has effects of immune regulation, antitumor, myocardial preservation, lipid lowering, etc.
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This study was aimed to observe influence of disease/syndrome on the toxicity and effect of aconite roots, in order to reveal relationship among disease/syndrome, toxicity and effect. The mice model of cold syn-drome was establish by wind-cold stimulation. The pain model was established by intraperitioneal injection of glacial acetic acid. Then, LD50 and ED50 of analgesic effect were compared, as well as the therapeutic index (TI) of crude aconite roots. The rat model of cold syndrome was also established by wind-cold stimulation. And the rheumatoid arthritis (RA) model was established by intracutaneous injection of CII and CFA. TD50 of cardiac toxic-ity and arthroncus degree of prepared aconite roots were compared among the normal rats, RA rats, RA with wind-cold stimulation rats according to the recording of lead II ECG. The results showed that after wind-cold stimulation, mice and rats appeared with symptoms which were similar to Chinese medicine cold syndrome. Com-pared with normal mice, LD50 and TI increased, but ED50 decreased in the group of wind-cold stimulation after using powders of crude aconite roots. Compared with normal rats, TD50 of cardiac toxicity and arthroncus degree in-creased in groups of RA and RA with wind-cold stimulation after using prepared aconite roots. It was concluded that in the case of disease/syndrome state, the toxicity of aconite roots decreased, but its effect increased. It sug-gested that there is a significant correlation among disease/syndrome, toxicity and effect.
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Toxicity of Chinese materia medica (CMM) is an important part of Chinese herbal nature theory. In clinical application, the dosage, time limitation and compatibility of CMM is mainly determined by toxicity. At present, there is no uniform toxicity classification standard for the evaluation of Chinese herbal toxicity. Therefore, it is significant to research toxicity classification of CMM. The current situation of toxicity classification of CMM is reviewed in this paper, and proposed research thoughts are as follows: the measurement of toxicity parameters, the confirmation of poisoning target organs, the investigation on toxic mechanism by serum pharmacology and toxicokinetics, the comprehensive evaluation on toxicity based on quantitative theory.
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Animals , Humans , Mice , Rats , Biomedical Research , China , Drugs, Chinese Herbal , Classification , History , Toxicity , History, Ancient , Materia Medica , Classification , History , Toxicity , Medicine, Chinese TraditionalABSTRACT
Objective To summarize the placement, maintenance, and safety of a high-pressure resistant peripherally inserted central catheter. Methods Ten patients were peripherally placed with this catheter (included 4Fr-single lumen, 5Fr-dual lumen, and 6Fr-three lumen) using ultrasound-guided Seldinger technique in Peking Union Medical College Hospital in August 2010. The therapeutic effectiveness and safety were evaluated. Result Ten catheters were inserted successfully into the upper arms, with few complications noted during routine maintenance. Conclusions This peripherally inserted central catheter can be used for high-pressure injection, central venous pressure monitoring, and fast flow-speed transfusion. Therefore, it can be successfully applied for contrast-enhanced CT angiography and massive fluid infusion.