Diagnóstico del acceso a servicios de salud gineco-obstetra de las mujeres internas en establecimientos penitenciarios del Perú

Introducción: Resulta trascendental estudiar el acceso a la salud en diversos campos y sobre todo en poblaciones en estado de vulnerabilidad. Las mujeres internas se consideran un grupo de población especial, el aumento sostenido de la población penitenciaria, a nivel local y mundial, y el hecho de que los problemas de salud de las personas privadas de libertad suelen ser de mayor prevalencia que la de la población general, plantea la necesidad y el desafío de diseñar y establecer estrategias especiales en referencia a los modelos de atención necesarios para llevar a cabo las tareas de atención, prevención y promoción de la salud dentro de los establecimientos penitenciarios. Objetivo: El objetivo del estudio fue diagnosticar el acceso a los servicios de la salud gineco-obstetra en los establecimientos penitenciarios del Perú durante el año 2021. Metodología: El estudio tiene carácter descriptivo, transversal, se realizó en el ámbito penitenciario y abarca todos los establecimientos penitenciarios de las regiones del Perú con población penitenciaria femenina distribuidas en el territorio peruano durante el año 2021. Para la recolección de datos se aplicó la técnica documental de fuente secundaria, el instrumento en el cual se registró la información recogida fue la ficha documental. Resultados: Se encontró que, de 13 establecimientos penitenciarios de mujeres y 31 pabellones de mujeres, solo 15 (34,09 %) cuentan con servicio gineco-obstetra, mientras que 29 (65,91 %) no cuentan con servicio gineco-obstetra. Del total de la población penitenciaria estudiada (4360) internas, no todas recibieron al menos una atención gineco-obstetra durante el año 2021 Discusión: El acceso a los servicios gineco-obstetras en la población penitenciaria de mujeres del Perú se muestra restringida, colocando en situación de vulnerabilidad a las mujeres privadas de su libertad.

Introduction: It is transcendental to study access to health in various fields and especially in populations in a state of vulnerability. Women inmates are considered a special population group, the sustained increase in the prison population, locally and globally, and the fact that the health problems of persons deprived of liberty tend to be more prevalent than that of the population in general, it raises the need and the challenge of designing and establishing special strategies in reference to the care models necessary to carry out the tasks of care, prevention, and health promotion within prisons. Objective: The objective of the study was to detect access to gynecologist-obstetric health services in penitentiary establishments in Peru during the year 2021. Methods: The study is descriptive, cross, was carried out in the penitentiary setting and covers all the penitentiary establishments in the regions of Peru with a female penitentiary population distributed throughout the Peruvian territory during the year 2021. For data collection, the secondary source documentary technique, the instrument in which the information collected was lost was the documentary file. Results: It was found that 13 women's prisons and 31 women's pavilions, of which only 15 (34.09%) have gynecologist-obstetric service, while 29 (35.91%) do not have gynecologist-obstetric service. Of the total prison population studied, 4,360 inmates, not all of them received at least one gynecologist-obstetrician care during the year 2021. Discussion: Access to gynecologist-obstetric services in the women's prison population in Peru is restricted, placing women deprived of their liberty in a situation of vulnerability.

Regular assessment is an effective approach to maintaining the capacity of prevention of re-establishment from imported malaria in China / 中国血吸虫病防治杂志

After achieving malaria elimination, preventing re-establishment from imported malaria and consolidating malaria elimination achievements are top priorities of the national malaria control program in China. Due to the long-term existence of overseas imported malaria cases and incomplete eradication of local epidemic conditions, there are multiple challenges for prevention of re-establishment from imported malaria in China. Hereby, we propose that regular assessment is an effective approach to maintaining the capability of prevention of re-establishment from imported malaria, and describe the purpose, significance, management and implementation of the capability assessment for prevention of re-establishment from imported malaria, so as to provide insights into the formulation and adjustment of malaria control strategies during the post-elimination phase.

Establishment and application of pediatric outpatient and emergency intelligent pharmacy service system in our hospital / 中国药房

OBJECTIVE To provide reference for the construction of intelligent pharmacy and quality control of each link in medical institutions. METHODS The problems， difficulties， and risk points in the links of prescription extraction， allocation， drug resource utilization， prescription and child information verification in pediatric outpatient and emergency pharmacy of our hospital were sorted out to put forward the solutions. The pediatric outpatient and emergency intelligent pharmacy service system of our hospital was established， and its effectiveness was analyzed. RESULTS & CONCLUSIONS In response to the risk points of drug accumulation， dispensing errors， being prone to complaints or disputes， safety hazards in dispensing， and pharmacist’s incorrect operation in various stages such as payment， taking medicine and dispensing， pediatric outpatient and emergency intelligent pharmacy service system was established in our hospital by adding intelligent queuing links， enabling “QR codes”， introducing devices such as rapid dispensing machines， intelligent drug racks， and intelligent dismantling machines. After using the system， the average outpatient dispensing speed increased from 37.55 s/piece to 16.97 s/piece （direct delivery prescriptions） and 27.10 s/piece （non-direct delivery prescriptions）， and the average emergency dispensing speed increased from 26.98 s/piece to 19.61 s/piece （P＜ 0.01）. The walking distance for pharmacists to dispense prescriptions had decreased from 4-16 m/piece to 2-5 m/piece， and the inventory rate had shortened from 2.0-2.2 h/time to 1.5-1.7 h/time. The rate of dispensing error decreased from 0.003% to 0 （P＜ 0.01）. At the same time， the improvement of pharmaceutical service quality has been demonstrated in terms of shortening the waiting time of family members of child， precise drug supplement and helping family members understand medication information. The application of the system can further promote pediatric outpatient and emergency pharmacy services in our hospital.

Establecimiento de biofloc a tres relaciones carbono/nitrógeno, tendiente a la producción de zooplancton / Establishment of biofloc at three carbon/nitrogen ratios, tending to the production of zooplankton

RESUMEN El objetivo de esta investigación fue establecer el biofloc a tres relaciones carbono/ nitrógeno (C/N): 10/1, 15/1 y 20/1, determinando la secuencia de remoción de N, el perfil de sólidos y la caracterización del zooplancton, para tal fin se dispuso de tres tanques con volumen de 7000 L, incorporando oxígeno al agua a través de un aireador tipo soplador. Se utilizó como fuente de N balanceado, fuente de carbono melaza y bicarbonato de sodio como fuente alcalinizante. Al inicio se incrementó el nitrógeno amoniacal total NAT a 2 mg/L, la alcalinidad total (AT) a 120 mg/L y se adicionó como inóculo 10 litros/tanque de agua proveniente de un estanque de cultivo, al sexto y décimo días se adicionó balanceado incrementando teóricamente el NAT en 4 mg/L y a partir del día 12 en 1 mg/L. En las tres relaciones C/N se evidenciaron procesos de nitrificación durante la estabilización del biofloc, hasta llegar en el tiempo a concentraciones no letales de amonio y nitrito para peces, menores a 1 mg/L. En cuanto a los sólidos volátiles, se encontró una mayor concentración en la relación 20/1, lo cual puede atribuirse a la mayor adición de melaza, con la consecuente producción de SSV a partir de la dominancia de comunidades heterotróficas, en los tres macrocosmos se presentaron comunidades del zooplancton, no obstante, el T2 presentaron la mayor abundancia y riqueza de organismos. Las tres relaciones C/N en biofloc establecieron condiciones de calidad de agua y alimento vivo.

ABSTRACT The objective of this research was to establish the biofloc at three carbon/nitrogen (C/N) relationships: 10/1, 15/1 and 20/1, determining the N removal sequence, the solids profile and the characterization of the zooplankton, for this purpose three tanks with a volume of 7000 L were available, incorporating oxygen into the water through a blower-type aerator. It was used as a source of balanced N, a source of carbon molasses and sodium bicarbonate as an alkalizing source. At the beginning, the total ammoniacal nitrogen NAT was increased to 2 mg/L, the total alkalinity (AT) to 120 mg/L and 10 liters / tank of water from a culture pond was added as inoculum, on the sixth and tenth days it was he added balanced, theoretically increasing the NAT by 4 mg/L and from day 12 by 1 mg/L. In the three C / N relationships, nitrification processes were evidenced during the stabilization of the biofloc, until reaching non-lethal concentrations of ammonium and nitrite for fish, less than 1 mg/L in time. Regarding volatile solids, a higher concentration was found in the 20/1 ratio, which can be attributed to the greater addition of molasses, with the consequent production of SSV from the dominance of heterotrophic communities, in the three macrocosms there were Zooplankton communities, however, T2 presented the highest abundance and richness of organisms. The three C / N relationships in biofloc established conditions of water quality and live food.

Evolutionary dynamics of autopolyploids in natural populations: the case of Turnera sidoides complex / Dinámica evolutiva de autopoliploides en poblaciones naturales: el caso del complejo Turnera sidoides

ABSTRACT Turnera sidoides (x=7) is one of the few well-studied South American autopolyploid complexes. Since polyploidy has played a prominent role within this complex, ongoing studies in T. sidoides focus on understanding the mechanisms involved in the origin and the establishment of polyploids using integrative approaches. This paper synthesises the results of more than 20 years of research on this topic. Cytogenetics analysis provided evidences for the production of unreduced male and female gametes, supporting the hypothesis of bilateral sexual polyploidization as the mechanism of origin of polyploids in T. sidoides. The finding of viable triploids suggested that unilateral sexual polyploidization could also be an important mechanism for the origin of tetraploids in T. sidoides. The occurrence of plants continuously forming many unreduced gametes would play a key role in the establishment of neopolyploids in natural populations. Also, the higher number of propagules that tetraploids contribute to subsequent generations, the ability to multiply asexually by rhizomes, and the occurrence of occasional cases of self-compatibility and successful illegitimate crosses in polyploids increase the likelihood that a low frequency of neopolyploids can be maintained in natural populations of T. sidoides. In addition, integration of cytogeographic and genetic divergence data together with past niche modelling provided further insights supporting the hypothesis that historical climatic and geomorphological events provided favourable conditions for the establishment of autopolyploids, with the wider distribution of tetraploids of T. sidoides being the result of their range expansion.

RESUMEN Turnera sidoides (x=7) es uno de los pocos complejos autopoliploides sudamericanos bien estudiados. Como la poliploidía ha tenido un papel destacado en el complejo, los estudios en curso en T. sidoides se centraron en la comprensión de los mecanismos implicados en el origen y el establecimiento de los poliploides mediante diferentes enfoques. En este trabajo se sintetizan los resultados de más de 20 años de investigación sobre este tema. El análisis citogenético proporcionó evidencias de la producción de gametos masculinos y femeninos no reducidos, sustentando la hipótesis de la poliploidización sexual bilateral como mecanismo de origen de los poliploides en T. sidoides. Sin embargo, el hallazgo de triploides fértiles sugirió que la poliploidización sexual unilateral también sería un mecanismo importante de origen de tetraploides en T. sidoides. La ocurrencia de plantas que forman continuamente gametos no reducidos desempeñaría un papel clave en el establecimiento de neopoliploides. Además, el mayor número de propágulos que los tetraploides aportan a las siguientes generaciones, la capacidad de multiplicación asexual por rizomas y los casos ocasionales de autocompatibilidad y cruzamientos ilegítimos exitosos aumentarían la probabilidad de que se mantenga una baja frecuencia de neopoliploides en las poblaciones naturales de T. sidoides. Asimismo, la integración de datos citogeográficos y de divergencia genética junto con el modelado de nicho en el pasado aportó información que sustenta la hipótesis de que los eventos climáticos y geomorfológicos históricos proporcionaron las condiciones favorables para el establecimiento y expansión de los tetraploides de T. sidoides.

Establishment and effect of standardized training base of dental nurses in Chongqing / 中华医学教育探索杂志

In order to build a standardized training base for dental nurses in Chongqing, explore and improve the dental nursing talent training system, the standardized training and management leading group of dental nurses has established a training program centered on job competence and a clinical competency training center based on simulated dental clinics, which has improved the comprehensive capabilities of dental nursing teachers, implemented the assessment of "equal emphasis on process and results" system, and taken measures to provide comprehensive protection to gradually build the base. After 6 years of construction, the base has completed the training of 139 dental nursing training students, with an average passing rate of 91.21%. Among them, 92.81%(129/139) are engaged in professional dental nursing work, and 14.73%(19/129) have grown into nursing backbones. In the future, it is necessary to further strengthen the standardized training and publicity of dental nurses and expand the scope of radiation.

Establishment and implementation of management information system for patients with stomas in cancer special hospital / 中国实用护理杂志

Objective:To establish and implement a management information system for patients with stomas based on the hospital information system.Methods:Relying on information system resources of Beijing Cancer Hospital, Beijing Institute for Cancer Research, the management information system for patients with stomas was developed by the Nursing Department and the Information Center from August 2018 according to the requirement of whole process management for patients with stomas.Results:A whole process management information system was constructed for patients with stomas including stoma construction, stoma care, management of complications and stoma closure. It was applied to 12 departments covering clinical departments and stoma clinics of the hospital, including 326 cases with stomas and 6 358 cumulative visits. 28 cases with skin complications around stoma were detected and the rate of complications was 8.59% (28/326) from May 2019 to October 2020.Conclusions:The management information system for patients with stomas can realize the whole-process management from stoma construction, stoma care, management of complications to stoma closure, and provide basis and guidance for nursing staff to implement professional nursing timely and accurately, which can also provide basis for continuously improving the quality of stoma care.

Neural network analysis of the correlation between malnutrition-induced stomatitis and vitamin B12 and folic acid / 口腔疾病防治

Objective@# A model was built by neural network analysis to study the relationship between different degrees of vitamin B12 and folic acid deficiency and malnutrition-induced stomatitis.@*Methods@# Data from 30 healthy volunteers and 30 patients with malnutrition-induced stomatitis were collected. The distribution of lesions, the number of affected sites and clinical manifestations were recorded, and the severity was scored. The levels of vitamin B12 and folic acid in the peripheral blood of the two groups were simultaneously measured. The SPSS software was used to analyze the correlation between vitamin B12 and folic acid levels in the peripheral blood of patients with malnutrition-induced stomatitis and healthy volunteers, and the MATLAB software package was used to analyze the data via a neural network.@*Results@#The levels of vitamin B12 and folic acid significantly correlated with the grade of malnutrition-induced stomatitis. Simultaneous B12 and folic acid deficiency linearly correlated with the occurrence and severity of malnutrition-induced stomatitis. Based on this correlation, a thermogram model of malnutrition-induced stomatitis was constructed.@*Conclusion@# Malnutrition-induced stomatitis is closely related to vitamin B12 and folic acid deficiency. Their synergistic effect may promote the occurrence and development of malnutrition-induced stomatitis. The construction of the malnutrition-induced stomatitis model aids the targeted etiological treatment of patients with moderate and severe deficiency to prevent malnutrition-induced stomatitis.

Analysis on testing ability of blood testing laboratories in domestic blood establishments across China / 中国输血杂志

【Objective】 To analyze testing ability of blood testing laboratories in domestic blood establishments, and to comprehensively understand the resource allocation, workload and unqualified blood samples. 【Methods】 All blood testing laboratories reported the quarterly quality indicator data via their EQA system on the website of National Center for Clinical Laboratories (https: //srv.clinet.cn/qblood/report/add1.aspx). We collected related quality indicators throughout 2020, including resource indicators, number of sample detection, and number (rate) of unqualified samples. All the data were integrated by EQA system. 【Results】 1) Throughout 2020, 324 blood testing laboratories reported that 13 529 778 donations were tested by immunoassays and 13 892 927 donations were tested by nucleic acid testing(NAT). Among them, 253 laboratories reported the data correctly throughout four quarters, and they tested 12 015 407 donations. 2) The number of equipment varied greatly among different laboratories, and a certain equipment was often overloaded in some laboratories. 3) The proportion of domestic ELISA reagents was 100% (322/322), while the proportion of imported NAT reagents was 75.33% (220/300). 4) The positive rate of HBsAg was closely related to geographical locations, as Sichuan (0.86%, 5 895/689 445), Guangdong (0.57%, 5 147/895 929), and Guangxi (0.53%, 3 021/573 216) provinces demonstrated higher positive rates than that of other provincial regions. 【Conclusions】 There are many blood stations across China, with great differences in scale and equipment. There are obvious differences in the positive rates of infectious indicators in different regions. Therefore, the laboratory should make horizontal comparison with the laboratories in the same region, to improve the detection quality of the laboratory in time and effectively.

Establishment and Evaluation of Ulcerative Colitis Animal Model in Combination of Disease and Syndrome / 中国实验方剂学杂志

Ulcerative colitis （UC） is one of the main manifestations of inflammatory bowel disease. Because of its lingering and refractory nature， it has become a major public health challenge worldwide. In the treatment of UC， traditional Chinese medicine （TCM） effectively relieves clinical syndromes， shortens the treatment period， reduces the frequency of recurrence， improves the quality of life， and reduces the occurrence of complications. To study the specific mechanism of TCM in the treatment of UC and screen out suitable drugs under the guidance of syndrome differentiation， the suitable UC animal model in the combination of disease and syndrome is used as an important method. This paper summarized and compared the UC animal model in the combination of disease and syndrome from five aspects， including selection of model animal species， sexual selection， preparation methods of UC animal model in the combination of disease and syndrome， indicators of model evaluation， and the main mechanism of TCM intervention in UC animal model in the combination of disease and syndrome. This paper aimed to provide references for the establishment of the optimal UC animal model in the combination of disease and syndrome. Research shows that UC syndrome mainly studied at present includes damp-heat syndrome， spleen deficiency syndrome， spleen-kidney Yang deficiency syndrome， spleen deficiency and dampness accumulation syndrome， liver depression and spleen deficiency syndrome， and cold-heat mixed syndrome.In the modeling method， the etiology simulation method is mainly used to first copy the syndrome type before the chemical agents or immune preparations were used to induce the disease model，and rats were often selected as the research objects，and the replication cycle was 7 to 28 days.The selected chemical reagents were mainly 5% dextran sulfate sodium（DSS） free drink, 2,4,6-trinitrobenzenesulfonic acid（TNBS） 100 mg·kg-1 and 50% ethanol 0.25 mL mixed reagent enema.This model replication method can take into account both UC pathogenesis characteristics of pathology of western medicine and TCM， syndrome type of traditional Chinese medicine and western medicine for interpretation pathological changes and TCM treatment of UC associated mechanism is of great significance， and help to help toestablish the optimal condition in combination with UC animal models for reference， for further research on prevention and treatment of UC specific mechanism of action of TCM model basis.

Construction of a risk assessment indicator system for re-establishment of imported malaria / 中国血吸虫病防治杂志

Objective To create a risk assessment indicator system for re-establishment of imported malaria. Methods The risk assessment indicator system for re-establishment of imported malaria was preliminarily constructed through literature review and thematic discussions. A total of 26 malaria control experts were selected to carry out a two-round Delphi consultation of the indicator system. The active coefficient, authority coefficient and coordination coefficient of the experts and the coefficient of variation on each indicator were calculated for indicator screening and the weight of each indicator was calculated. The reliability of the indicator system was evaluated using Cronbach’s coefficient α, and the content validity of the indicator system was evaluated using the authority coefficient of the expert, while the structural validity of the indicator system was evaluated using Kaiser-Meyer-Olkin (KMO) test and factor analysis. Results Two rounds of Delphi expert consultations were completed by 23 malaria control experts, and a risk assessment indicator system for re-establishment of imported malaria was constructed, including 3 primary indicators, 7 secondary indicators, and 21 tertiary indicators. The active coefficient (100.00% vs. 88.46%; P < 0.01) and coordination coefficient of the expert (0.372 vs. 0.286; P < 0.01) were significantly greater in the second round of the Delphi expert consultation than in the first round. After the second round of the Delphi expert consultation, the authority coefficient of the experts ranged from 0.757 to 0.930 on each indicator, and the coefficients of variation were 0.098 to 0.136, 0.112 to 0.276 and 0.139 to 0.335 for the primary, secondary and tertiary indicators, respectively. The overall Cronbach’s coefficient α of the indicator system was 0.941, and there were significant differences in the KMO values for primary (KMO value = 0.523; χ2 = 18.192, P < 0.05), secondary (KMO value = 0.694, χ2 = 51.499, P < 0.01) and tertiary indicators (KMO value = 0.519; χ2 = 477.638, P < 0.01), while the cumulative contribution rate of six principal components in the tertiary indicators was 84.23%. The normalized weights of three primary indicators of the source of infection, transmission condition and control capability were 0.337, 0.333 and 0.329, and the three secondary indicators with the greatest normalized weights included the number of imported cases and malaria parasite species (0.160), introduction of imported cases in China and medical care seeking (0.152), vector species and density (0.152), while the five tertiary indicators with the greatest normalized weights included the malaria parasite species of imported cases (0.065), vector populations (0.064), and the time interval from onset to medical care seeking (0.059), number of imported cases (0.056), and the time interval from medical care seeking to definitive diagnosis (0.055). Conclusions A risk assessment indicator system for re-establishment of imported malaria is successfully created, which provides insights into the assessment of the risk of re-establishment of imported malaria and management of key high-risk factors in malaria-eliminated areas.

INFLUENCIA DE LA HERBIVORÍA Y LA APERTURA DE CLAROS SOBRE EL CRECIMIENTO TOTAL DE Brosimum alicastrum (Moraceae) / Influence of herbivory and gap-openness on whole-plant growth of Brosimum alicastrum (Moraceae)

RESUMEN El crecimiento compensatorio y las defensas vegetales son respuestas para lidiar con la herbivoría y la luz. El estudio de la influencia de los componentes morfo-fisiológicos, de la asignación de biomasa y de la defensa vegetal podría arrojar información que ayude a entender estas respuestas. Se evaluaron los efectos de la herbivoría y la apertura de claros sobre el crecimiento, los componentes morfo-fisiológicos, la asignación de biomasa y las defensas químicas y físicas en plántulas de Brosimum alicastrum en una selva mediana subcaducifolia. Se utilizó un diseño anidado con sitios de sotobosque y claros (n = 3 en cada uno) y dentro de ellos plántulas sometidas a tres tratamientos de herbivoría: control (n = 10), simulada (n = 10) y natural (n = 10). Se registró a lo largo de seis meses la influencia de la herbivoría sobre el crecimiento (biomasa, área foliar, altura, diámetro y producción de hojas), la producción de fenoles y la dureza foliar. Se halló un crecimiento compensatorio (todas las variables de crecimiento) con la herbivoría natural, subcompensatorio (biomasa, altura y diámetro) con la simulada, y sobrecompensatorio (producción de hojas) con la herbivoría natural sólo en claros. Los componentes morfológicos como el cociente del área foliar (LAR) y el área foliar específica (SLA) fueron mayores bajo claros y el fisiológico, como la tasa de asimilación neta (NAR), en sotobosque. La proporción de biomasa en sotobosque fue mayor hacia hojas y tallos y en claros más alta hacia raíces. La herbivoría fue mayor en claros y los fenoles foliares en sotobosque. No se encontró una relación (compromiso) entre las defensas y el crecimiento, sólo una tendencia negativa con los fenoles bajo condiciones limitantes de recursos, como ocurre en el sotobosque.

ABSTRACT Compensatory plant growth and plant defense are responses to deal with herbivory and light availability. The research focused on compensatory growth responses explained through the influence of morphological and physiological components of plant growth, allocation mass, and plant defense could clarify such process. We studied the effects of herbivory and gap-openness on compensatory growth responses, morphological and physiological components, allocation mass, and chemical defenses in seedlings of Brosimum alicastrum in a subhumid tropical forest. We used a nested design with understory and gap-openness site (n = 3 each) within each replicated site seedling belong to three herbivory treatments (n = 10 each): control, simulated, and natural; and along six months we studied the influence of leaf herbivory on plant growth (mass, leaf area, height, diameter, and leaf production) and production of phenols and leaf toughness. We recorded compensatory growth responses (all plant growth variables) with natural herbivory, subcompensatory (mass, height, and diameter) with simulated and, overcompensatory (leaf production) with natural herbivory although only under gap-openness. We found a higher leaf area ratio (LAR) and specific leaf area (SLA) (both morphological components) under gap-openness and high values of net assimilation rate (NAR) on understory. The mass proportion was highest in leaves and stems on the understory and higher in roots under gap-openness. Leafherbivory was highest under gap-openness while the phenols of the leaves on understory. We did not find a relationship (trade-off) between defense with plant growth, but it was possible to underline a negative pattern of the leaf phenols under limiting resources environment such as understory.

Establishment and practical effect of comprehensive clinical management for out patients with orthotopic new bladder based on doctor-nurse cooperation / 中国实用护理杂志

Objective:To build a comprehensive clinical management of outpatient with orthotopic neobladder based on doctor-nurse cooperation to provide overall service to patients.Methods:The comprehensive clinical management was established in October 2018, 32 patients were collected retrospectively from January 2009 to before the establishment of the clinic, and 14 patients were collected from the establishment of the clinic to January 2020. After the establishment of the clinic, the comprehensive management mode was adopted, including the medical team implementing management from the aspects of implementing doctor-patient joint decision-making, guiding patients to carry out pelvic floor muscle rehabilitation training, teaching family members to carry out new bladder irrigation, and establishing patients′ records. Before the establishment of the clinic, there was no specialized personnel for unified management, and the doctor for new bladder irrigation and so on.Results:The rate of complete urinary control in the 46 patients with orthotopic neobladder was 82.6%(38/46) in the day and 71.7%(33/46) in the night. The rates of complete urine control of patients in the day and night were 12/14 and 9/14 after the establishment of the clinic. The length of stay which was (13.36 ± 9.44) d, and feeding time which was (5.00 ± 2.11) d of the patients after the establishment of the clinic were both less than those of the patients before the establishment of the clinic, which were (17.28 ± 9.98) d and (5.78 ± 2.90) d, but the differences were not statistically significant ( t values were -1.247 and -0.905 respectively, both P>0.05). However, for diurnal and night-time urine control, the proportion of people with more than one diaper was better after the establishment of outpatient clinic than before. Conclusions:The establishment of the comprehensive clinical management meets the needs of patients with orthotopic neobladder, enables patients to get the function of continence and urination sooner, and contributes to improve the clinical outcome of patients.

Investigation and analysis on the current situation of clinical practice guidelines for acupuncture and moxibustion at home and abroad / 中国针灸

To provide directional suggestions for the establishment of international clinical practice guidelines for acupuncture and moxibustion by investigating the current situation of clinical practice guidelines for acupuncture and moxibustion at home and abroad. The clinical practice guidelines were obtained by questionnaire survey, database retrieval and experts consulting. The guidelines were read carefully, and the content was analyzed. A total of 27 acupuncture-moxibustion clinical practice guidelines were retrieved, of which most of the guidelines came from China. The definition and scope of "acupuncture and moxibustion "vary according to different guidelines; and the focus of the content and the method of establishing the guidelines are quite different, so it is very necessary to unify the formulation methods of acupuncture-moxibustion clinical practice guidelines. Chinese clinical practice guidelines for acupuncture and moxibustion were characterized by taking the ancient literature as the evidence. Excavating the value of ancient literature and clinical experience of acupuncture-moxibustion experts are the key points and difficulties in the developing of clinical practice guidelines of acupuncture and moxibustion in the future.

Application and practice of risk assessment in clinical research project approval / 中华医学科研管理杂志

Objective:Through the analysis of the risk factors of clinical scientific research project, risk assessment theory was brought in to develop risk assessment procedures, at the same time, to explore possible applications of risk assessment theories and methodologies in clinical scientific research projects, which might empower the research project administration.Methods:Through literature review and the author's scientific research management daily practice, the characteristics of risks involved in clinical scientific research projects were systematically summarized, relevant standards and models were used for reference to develop relevant working procedures, fatherly, methodologies of project risk assessment were discussed.Results:There are risks at different stages of scientific research project that including compliance, safety, research topic selection, research design, executive ability and risk-control. A proposal regarding to the implementation of project risk assessment covers three main steps which including preliminary preparation, implementation of risk assessment (risk identification, risk analysis and risk assessment) and risk-response proposal.Conclusions:The risk assessment of clinical scientific research projects is crucial. It is necessary to promote the development of risk assessment and improve the capacity building by improving awareness, establishing system, clarifying structure and improving technology.

Clinical characteristics and prognostic model of colorectal cancer based on SEER database / 国际外科学杂志

Objective:To investigate the important risk factors for the prognosis of patients with colorectal cancer (CRC) based on SEER database, and to construct a line chart prognostic model of 1-, 3-and 5-year survival rates for CRC patients.Methods:The clinical data of 52814 patients with CRC diagnosed pathologically from 2010 to 2015 in SEER database were collected. Cox proportional hazard model was used for univariate and multivariate survival analysis to determine the prognostic risk factors. Stepwise regression was used to screen the clinical factors that had the greatest impact on prognosis. Calibration curve was used to evaluate the accuracy of line chart prediction model for predicting 1-, 3-and 5-year OS in patients with CRC.Results:Surgical method, age, LNR, AJCC stage, T stage, N stage, M stage, vascular tumor thrombus and nerve invasion were independent risk factors for prognosis. Stepwise regression analysis showed that age, T stage, M stage, LNR and mode of operation were the most associated with the prognosis of CRC. A line chart model was constructed based on these five factors. The consistency index of age/T staging/M staging/LNR/ operation on the training set and verification set was the highest, which were 0.762 and 0.756 respectively. ROC curve analysis showed that in the training set and verification set, the AUC of age/T stage/M stage/LNR/ operation prognosis model was more than 0.7, and the model had high diagnostic value.Conclusion:The CRC prognostic line chart model based on age/T staging/M staging/LNR/ operation has a better predictive effect. The constructed prognosis OS diagram is convenient for clinical oncologists to make a more accurate assessment of the prognosis of patients, and provides a theoretical basis for individual diagnosis and treatment of CRC patients.

A guangxi bama minipig model of trimeresurus stejnegeri snakebite: Modeling and evaluation / 中国组织工程研究

BACKGROUND: At present, there are not many research methods on the pathological mechanism of Trimeresurus stejnegeri snakebite, and there are few methods for constructing animal models. OBJECTIVE: To establish and evaluate the Guangxi Bama minipig model for research on the pathological mechanism, diagnosis and treatment of Trimeresurus stejnegeri snakebite. METHODS: Based on the 50% lethal dose of intramuscularly injected Trimeresurus stejnegeri venom to mice, the theoretical 50% lethal venom dose for Bama minipigs was calculated by the equivalent dose coefficient conversion and reduction algorithm, and the body surface area conversion algorithm. Twelve Bama minipigs were randomly divided into a normal group (n=6) and a model group (n=6). The model group was injected intramuscularly with 0.2 mL/kg snake venom 1/3 of the theoretical 50% lethal dose (0.643 mg/kg). The control group was injected with the same amount of normal saline. After snake venom injection, the poisoning symptoms of Bama minipigs were observed. Two groups of animal blood samples were collected before, 6 hours and 24 hours after snake venom injection. Blood routine test, four coagulation items, blood biochemistry and electrolyte were detected. Histopathological changes of the heart, brain, lung, liver, and kidney as well as the injection site were observed by hematoxylin-eosin staining. The study protocol was approved by the Laboratory Animal Ethics Committee (approval No. 201909013). RESULTS AND CONCLUSION: There was swelling at the wound of the piglet accompanied with blood blisters after snake venom injection. The affected limbs and the surrounding area were swollen and spread rapidly to the proximal end. The piglets walked all the time because of the pain, and no animal died during the experiment. Compared with the control group pig, the model group had higher red blood cell count, white blood cell count, alanine aminotransferase, D-dimer count, longer prothrombin time, and lower fibrinogen and platelet count. Hematoxylin-eosin staining showed that, compared with the control group, capillary permeability of piglet lung tissues in the model group was increased with hyperemia and edema. Edema, bleeding, degeneration and necrosis were seen in the muscle tissue on the injection site. No obvious abnormalities in other organs and tissues were observed. To conclude, this method can be used to establish a pig model of Trimeresurus stejnegeri snakebite that can reflect the pathophysiological process of Trimeresurus stejnegeri snakebite. It has operability and repeatability that can be used to study the pathophysiological mechanism of Trimeresurus stejnegeri snakebite.

Construction of a drug screening model for miscarriage from induced pluripotent stem cells in vitro / 药学学报

Drug use during pregnancy is unavoidable. Therefore, it is vitally important for medical workers to help pregnant women take drugs correctly to reduce the incidence of spontaneous abortion, premature birth, and low birth weight. In our study, drug screening model with induced pluripotent stem cells (iPSCs) was used to find some improper drugs which will result in woman's abortion. With 3D culture in vitro, iPSCs can form embryoid bodies (EBs) and cerebral organoids, which simulated in vitro development of early embryos, from inner cell mass to germ-layer differentiation. In the experiment, EBs were exposed to mifepristone (RU486), and three experimental groups were divided randomly. They were control group (without RU486), low-dose group (L-RU486, 10 μg·mL-1), and high-dose group (H-RU486, 20 μg·mL-1). After mifepristone exposure, EBs were observed at days 5, 8, and 11, including size of EB, cell apoptosis, and differentiation of germ layers, by using inverted optical microscope, TUNEL assay, and immunofluorescent staining. The results showed that through 3D culture, iPSCs could develop into embryoid bodies, neural rosettes, and finally cerebral organoids. After mifepristone exposure, EBs' sizes were decreased (P < 0.01); the levels of cell apoptosis in EBs were increased after mifepristone exposure (P < 0.01); the development of EBs' germ layer was affected. Mifepristone exposure could inhibit the proliferation of embryonic stem cells, reduce the differentiation of ectoderm (P < 0.01) and promote the development of mesoderm (P < 0.05). In conclusion, iPSCs can be used as a screening model for abortion drug, and EBs’ diameter, cell apoptosis, and differentiation changes of the germ layers can serve as criteria of abortion drug screening.

Challenges and countermeasures in prevention of re - establishment of imported malaria in China / 中国血吸虫病防治杂志

Malaria was one for the most serious communicable diseases in China. Following the concerted efforts for decades, remarkable achievements have been gained for malaria control in China. Since the national malaria elimination programme was initiated in China in 2010, local malaria transmission was rapidly interrupted, with zero indigenous malaria case reported for the first time in the country in 2017, and the country will undergo the certification of malaria elimination by WHO. Currently, however, malaria remains hyper-endemic across the world. In China, there are more than 2 000 overseas imported malaria cases each year, and prevention of re-establishment of imported malaria will become the major task in future malaria control activities. Here by, we analyze the main challenges in the prevention of re-establishment of imported malaria in China, and propose the corresponding countermeasures, so as to provide insights into the consolidation of malaria elimination achievements.

Solilóquios com um fósforo queimado: notas do cafezinho / Soliloquies with a burnt matchstick: notes from the coffee break / Soliloquios con un partido quemado: notas de café / Soliloques avec une allumette brûlée: notes de café

As intuições originais de Freud se verticalizaram em aprofundamentos teórico-clínicos e se horizontalizaram tornando-se populares. Em ambos os sentidos, o movimento trouxe novos desafios para a comunicação, tanto em sentido alongado, com o grande público, como em sentido lateral, de diálogo entre pares. Apreensões que privilegiam disjunções, e não cesuras entre novos desenvolvimentos epistemológicos e teorias consagradas, podem contribuir para um sentimento de expansão dispersiva do universo de discurso em psicanálise. Por fim, analisa-se o desafio que representa a vulgarização de formulações geniais, passíveis de um processo de kitschização epistemológica, com subtração de seus aspectos subversivos.

Freud's original intuitions became vertical in theoretical-clinical depths and horizontalized becoming popular. In both directions, the movement brought new challenges for communication, both in an elongated sense, with the general public, and in a lateral sense, of dialogue between peers. Apprehensions that privilege disjunctions, and not caesuras between new epistemological developments and established theories can contribute to a feeling of dispersive expansion of the universe of discourse in psychoanalysis. Finally, we analyze the challenge that represents the vulgarization of brilliant formulations, subject to a process of epistemological kitschization and subtraction of its subversive aspects.

Las intuiciones originales de Freud se volvieron verticales en profundidades teórico-clínicas y se horizontalizaron volviéndose populares. En ambas direcciones, el movimiento trajo nuevos retos para la comunicación, tanto en sentido alargado, con el público en general, como en sentido lateral, de diálogo entre pares. Las aprehensiones que privilegian las disyunciones y las no vacilaciones entre los nuevos desarrollos epistemológicos y las teorías establecidas pueden contribuir a un sentimiento de expansión dispersiva del universo del discurso en psicoanálisis. Finalmente, analizamos el desafío que representa la vulgarización de formulaciones brillantes, sometidas a un proceso de kitschización epistemológica y sustracción de sus aspectos subversivos.

Les intuitions originales de Freud sont devenues verticales dans les profondeurs théorico-cliniques et horizontalisées devenant populaires. Dans les deux sens, le mouvement a apporté de nouveaux défis de communication, à la fois dans un sens allongé, avec le grand public, et dans un sens latéral, de dialogue entre pairs. Les appréhensions qui privilégient les disjonctions, et non les césures entre les nouveaux développements épistémologiques et les théories établies peuvent contribuer à un sentiment d'expansion dispersive de l'univers du discours en psychanalyse. Enfin, nous analysons le défi que représente la vulgarisation de formulations brillantes, soumises à un processus de kitschisation épistémologique et de soustraction de ses aspects subversifs.