Application of 6S and PDCA cycle lean management in nursing management of orthopedic trauma surgery / 中华创伤杂志

Objective:To explore the application effect of 6S and PDCA cycle lean management in nursing management of orthopaedic trauma surgery.Methods:A retrospective cohort study was conducted to analyze the clinical data of 80 patients with orthopedic trauma admitted to University-Town Hospital of Chongqing Medical University from January 2020 to November 2021, including 51 males and 29 females; aged 23-68 years [(44.5±9.2)years]. According to the order of operation date, 40 patients from January 2021 to November 2021 received routine management plus 6S and PDCA cycle lean management (lean management group), and 40 patients from January 2020 to December 2020 received routine surgical nursing management (routine management group). The nursing quality score in operating room (instrument and equipment management, surgical instrument preparation, surgical coordination, disinfection and isolation), qualified rate of infection monitoring in operating room (air in operating room, hand hygiene of medical staffs and sterile articles in operating room), surgeons′ satisfaction with operating nurses (circulating nurses and scrub nurses), self- rating anxiety scale (SAS) of patients before operation, incidence of complications at postoperative 12 days and patients′ satisfaction with nurses in operating room at postoperative 2-3 days.Results:The four dimensions of the nursing quality score in operating room in lean management group were (27.8±1.5)points, (18.1±1.1)points, (26.6±1.5)points and (18.1±0.8)points, significantly higher than (23.7±2.3)points, (14.6±1.1)points, (22.4±1.8)points and (13.7±1.1)points in routine management group (all P<0.01). The three dimensions of qualified rate of infection monitoring in operating room in lean management group were all 100%, showing no significant differences in routine management group (75%, 100%, 100%) (all P>0.05). Surgeons′ satisfaction with circulating nurses and scrub nurses in lean management group was 90% and 85%, higher than 73% and 65% in routine management group (all P<0.05). Preoperative SAS in lean management group was (32.5±8.2)points, significantly lower than (54.6±10.7)points in routine management group ( P<0.01). The incidence of postoperative complications in lean management group was 0, significantly lower than 15%(6/40) in routine management group ( P<0.05). Patients′ satisfaction with nurses in operating room in lean management group was 95% (38/40), significantly higher than 78%(31/40) in routine management group ( P<0.05). Conclusion:6S and PDCA cycle lean management can effectively improve the nursing quality of orthopedic trauma surgery, reduce patients′ anxiety and postoperative complications, and improve surgeons′ and patients′ satisfaction, which is worthy of further clinical application.

Characteristics of auditory steady-state response in first-degree relatives of schizophrenic patients under eye-open/closed state / 中华行为医学与脑科学杂志

Objective:To study the effect of eye-open/closed state on 40 Hz auditory steady state response (ASSR) in first-degree relatives of schizophrenia.Methods:Thirty-eight first-degree relatives of schizophrenic patients treated in Shanghai Mental Health Center from March 2010 to October 2011 were selected, and 31 healthy controls were recruited in the same period. All subjects were assessed with schizotypal personality questionnaire (SPQ). The 40 Hz EEG ASSR signals lasting for 3 min under open and closed eyes of all subjects were sequentially collected.Event-related spectrum perturbation (ERSP) and intertribal phase coherence (ITC) were used to evaluate ASSR. SPSS 22.0 software was used for statistical analysis. Two-way analysis of variance was used to compare ITC and ERSP between the two groups under open and closed eyes. Spearman correlation analysis was used to analyze the correlation between each measurement.Results:ITC in group main effect and group×the eye open/closed interaction effect were not significant (both P>0.05), but the main effect of eye-open and eye-closed was significant ( F(1, 67)=10.61, P=0.002). In the healthy control group, the ITC in eye-open state was significantly higher than that in eye-closed state ( P=0.014), and in the first-degree relatives group, the ITC in eye-open state was higher than that in eyes closed state ( P=0.039). ERSP in the main effect of eye-open and eye-closed ( F(1, 67)=0.195, P=0.660), group main effect ( F(1, 67) =0.627, P=0.431), group × the eye-open/closed interaction effect ( F(1, 67)= 1.034, P=0.313) was not significant. Spearman correlation analysis showed that there was no correlation between ERSP (eye open: r=-0.260, P=0.210; eye closed: r=-0.318, P=0.122), ITC (eye open: r=-0.248, P=0.232; eye closed: r=-0.260, P=0.209) and SPQ score in the healthy control group. There was also no correlation between ERSP (eye open: r=-0.387, P=0.226; eye closed: r=-0.363, P=0.238) or ITC (eye open: r=0.126, P=0.485; eye closed: r=0.096, P=0.595) and SPQ score in the first-degree relatives group of schizophrenia. Conclusion:The regulation pattern of 40 Hz ASSR in schizophrenic first-degree relatives is not significantly impaired in the eye-open/closed state, suggesting that the open/closed regulation pattern of 40 Hz ASSR may not be a potential marker for predicting the genetic high-risk prognosis of schizophrenia.

A study of event-related potential P300 in subjects with clinical high risk of psychosis / 中国神经精神疾病杂志

Objective To investigate the characteristics of auditory P300 amplitude and latency and cognition in patients with clinical high-risk of psychosis (CHR). Method Thirty six CHR (study group) and thirty five healthy con?trols (control group) were included. Oddball paradigm and MATRICS Consensus Cognitive Battery (MCCB) were used to record auditory P300 and to evaluate the cognition, respectively. The structured interview for psychosis-risk syndromes (SIPS) was used to evaluate the clinic symptoms of patients. Result The cognition of CHR was significantly lower than healthy controls in information processing, attention/vigilance, working memory, verbal learning, visual learning, reason?ing and problem solving and social cognition (P<0.01). The study group showed decreased amplitude in Fz, Cz and Pz and delayed latency in Pz (P<0.05). P300 latency of CHR in Fz positively correlated with positive score of SOPS (r=0.544, P=0.001), while P300 amplitude positively correlated with verbal fluency (r=0.339,P=0.043). Conclusion Cogni?tion and P300 is abnormal in CHR. The correlation between P300 and clinical symptoms, cognitive dysfunction reminds that we should put more attention on the role of P300 in CHR subjects.

Effect of mild hypothermia on expression of small ubiquitin-like modifier-specific proteases 3 in brain tissues during cerebral ischemia-reperfusion in mice / 中华麻醉学杂志

Objective To investigate the effect of mild hypothermia on the expression of small ubiquitin-like modifier-specific proteases 3 (SENP3) in the brain tissues during cerebral ischemia-reperfusion (I/R) in mice.Methods Ninety-six male C57/BL6 mice,aged 10-12 weeks,weighing 22-30 g,were randomly divided into 3 groups (n =32 each) using a random number table:sham operation group (group S),group I/R,and mild hypothermia group (group H).Cerebral I/R was produced by occlusion of bilateral common carotid arteries for 15 min followed by reperfusion.The surface cooling was started immediately after reperfusion,and the rectal temperature was maintained at 32-34 ℃ for 3 h.At 6,12,24 and 72 h of reperfusion,8 mice were selected from each group and sacrificed.The hippocampi were removed for examination of the pathological changes (with light microscope) and for determination of cell apoptosis (using TUNEL) and expression of SENP3 (by Western blot).The apoptosis rate was calculated.Results Compared with group S,the apoptosis rate in hippocampal CA1 region was significantly increased,and the expression of SENP3 was significantly up-regulated at each time point of reperfusion in group I/R (P＜0.05).Compared with group I/R,the apoptosis rate in hippocampal CA1 region was significantly decreased,and the expression of SENP3 was significantly down-regulated at each time point of reperfusion (P＜0.05),and the pathological changes were significantly reduced in group H.Conclusion The mechanism by which mild hypothermia reduces cerebral I/R injury is associated with inhibition of SENP3 expression in the brain tissues of mice.

Infiltration and activation of neutrophils in lung tissues during Chlamydia muridarum respiratory tract infection / 中华微生物学和免疫学杂志

Objective To investigate the possible mechanism of aggregation and activation of neu-trophils(polymorphonuclear neutrophils,PMN)in mice with chlamydial pneumonitis. Methods C57BL/ 6 mice were inoculated intranasally with 3×103 inclusion-forming units(IFU)of Chlamydia muridarum(Cm) to induce the murine model of chlamydial pneumonitis. Samples of lung tissues collected at different time points after infection were stained by hematoxylin and eosin for histopathological assessment of inflammation. The levels of myelo-peroxidase(MPO)were detected for the evaluation of PMN aggregation. The mononu-clear cells were isolated from lung tissues. The inflammatory cells were counted with Giemsaˊs staining. CD11b+Gr1+ cell population and CD11b expression in lung mononuclear cells were analyzed by flow cytome-try. The expression of chemokines(MIP-2,LIX,KC and MCP-1)in lung tissues at mRNA level was meas-ured by RT-PCR. Results Chlamydial pneumonitis was induced in mice by intranasal inoculation of 3×103 IFU of Cm. Compared with the mice from control group,large amounts of inflammatory cells including PMN, monocytes and lymphocytes were induced in lung tissues of mice with Cm infection. PMN responded earlier than monocytes to the infection. The levels of MPO were significantly increased in mice with Cm infection and reached the highest level on the 7th day after infection. A decline in MPO levels was observed on the 14th day but the levels were still higher than those on day 0. The percentages and total numbers of CD11b+Gr1+ cells were significantly increased after Cm infection. Moreover,an increased expression of PMN CD11b was also detected by flow cytometry. The expression of chemokines(MIP-2,LIX,KC and MCP-1)was in-creased in lung tissues of mice after Cm infection. The results of the study indicated that Cm infection in-duced the expression of PMN chemoattractants,resulting in the recruitment of PMN. Conclusion The infil-tration and activation of PMN in lung tissues of mice were induced by Cm infection through increasing the ex-pression of chemokines. PMN played an important role in immune responses against Cm infection.

Brain functional connectivity in depression during emotion processing / 生物医学工程学杂志

Cognitive and emotional dysfunction in depressed patients has been broadly researched. However, the physiological mechanism of the emotional impairment is still obscure. In this study, according to the ethical principles and the procedures of informed consent, we enrolled 16 depression patients and 16 normal subjects in a "learning-judgment" cognitive task. Emotional faces were chosen and used as the visual stimuli, while the subjects' scalp electroencephalographs (EEG) were recorded. We calculated the coherences of the event-related EEG signals between different functional brain regions and used the repeated measure analysis of variance (ANOVA) to analyze the coherences. The results revealed, (1) The depressed patients had a significantly lower inter-hemisphere coherence than did the normal controls at frontal sites across all EEG basic rhythms; (2) The inter-hemispheric coherence of EEG beta activity was significantly correlated with the emotional processing during 1-200 ms after stimulus onset, and the synchronicity with the negative emotion stimulus was higher than that with neutral and positive stimuli; (3) The main effect of race was found at delta and theta bands at about 401-600 ms after stimulus onset. Moreover, the connectivity of inter-hemisphere for own-race stimulus was stronger than that for other-race stimulus.

Entropy analysis of the EEG alpha activity in depression patients / 生物医学工程学杂志

The alpha rhythm in electroencephalograph has been associated with the mental state of the brain. The aim of the present study was to analyze the complexity of the alpha activity in depression patients by Renyi entropy (RE) under two conditions, i.e., resting with eyes closed followed by a simple mental arithmetic. The EEGs were recorded in 20 depression patients and 20 age-matched control subjects. Results showed that the alpha activity of depression patients is more complex during resting and is more regular during the mental arithmetic than that of the controls. RE analysis can well characterize the alpha activity in depression patients and could be a valuable tool to study cognitive process and also a potential effective approach for the diagnosis of depression.