Prevention and control strategies of physical examination and health consultation for apheresis donation during the COVID-19 outbreak / 中国输血杂志

【Objective】 To discuss the prevention and control strategies of physical examination and health consultation for apheresis donation during the COVID-19 outbreak, and to verify its necessity and efficiency. 【Methods】 A three-stage (Hubei import period, Jan 23 to 31; local(Zhejiang) epidemic period( Feb 1 to Mar 1); overseas import period, Mar 2 to 22) prevention and control strategy for physical examination and health consultation during the COVID-19 outbreak from January 23 to March 22, 2020 was adopted by our center, and the consultation of residence history, contact history, and the investigation of related symptoms were added to health consultation.The deferral rates of health consultation and physical examination during the COVID-19 outbreak were compared with the same period in 2019. The deferral rates in each stage were compared, containing those contributed by first-time and regular apheresis donors. 【Results】 The deferral rates of health consultation during the epidemic period and the same period in 2019 were 2.31%(100/4 371) vs 1.62%(78/4 740) (P0.05) The deferral rate of travel contact history was the highest at 2.05%(40/1947)during local epidemic period, and respiratory symptoms at 1.29%(5/388)during Hubei import period. The deferral rates of blood pressure during the three stages were1.85%(7/378)vs 3.57%(67/1877)vs 4.08(82/2009)(P>0.05). The deferral rate of health consultation and physical examination in first-time and regular apheresis donors were 5.86%(38/649)vs 1.65%(61/3 696)and 5.79%(35/604)vs 3.41%(124/3 635)(P<0.01). 【Conclusion】 The deferral rates of health consultation and physical examination increased significantly during the COVID-19 epidemic. Therefore, it is necessary to formulate and adopt a targeted consultation strategy during the epidemic period to block COVID-19 transmission to the greatest extent.

Application of fiberoptic bronchoscopy in the treatment of residual foreign bodies in children / 中国耳鼻咽喉头颈外科

OBJECTIVE To evaluate the clinical value of fiberoptic bronchoscopy in the treatment of residual foreign bodies in children after rigid ronchoscopy.METHODS Fiberoptic bronchoscopy was performed in 18 children with residual foreign bodies in the distal bronchus after rigid bronchoscopy between 2012.01 to 2016.12.RESULTS Foreign bodies were found in 17 children,only one case did not found foreign body and was considered to be coughed out.The Foreign bodies were removed in 12 cases under fiberoptic bronchoscopy one time and 5 cases under fiberoptic bronchoscopy more than 2 times.All patients had no laryngeal edema,subcutaneous emphysema,pneumothorax,longitudinal diaphragm emphysema and pneumonia by chest X-ray postoperatively.CONCLUSION Fiberoptic bronchoscopy is a safe and effective method for the diagnosis and treatment of deep residual foreign bodies in children after rigid bronehoscopy.

Effect of nebulized hypertonic saline solution for bronchiolitis in infant / 中国基层医药

Objective To assess the efficacy and safety of nebulized hypertonic saline solution in infant with bronchiolitis.Methods From January 2014 to January 2016,95 patients at 3-13 months old in our hospital who diagnosed as bronchiolitis were randomly divided into three groups.On the basis of conventional suit support treatment,the observation group A was given nebulized 3％ hypertonic saline (n =32),the observation group B was given nebulized 3％ hypertonic saline and salbutamol (n =32),and the control group C was given nebulized normal saline (0.9％) and salbutamol (n =31),this therapy was repeated every 6 hours until discharge.The Lowell score,clinical symptoms remission time,days of hospitalization and incidence rate of adverse reaction of the three groups were compared.Results After treatment,the symptoms and signs of the three groups were all improved.The Lowell scores were lower in the two observation groups compared to the control group C in 24,48,72 hours after treatment[(5.81 ±1.53) points and (5.85 ± 1.37) points vs.(6.61 ± 1.54) points,(4.75 ± 1.34) points and (4.72 ± 1.30) points vs.(5.52 ± 1.29) points,(3.19 ± 1.15) points and (3.22 ± 1.16) points vs.(3.90 ± 1.01) points,Z =-1.999,-2.241,-2.518 and-2.002,-2.335,-2.316,all P ＜ 0.05).And the cough,wheezing remission time and pulmonary rales disappearance time,days of hospitalization in the two observation groups were also shorter,there were statistically significant differences [(6.63 ± 1.41) d and (6.56 ± 1.37) d vs.(7.35 ± 1.25) d,(5.19 ± 1.03) d and (5.25 ± 1.05)d vs.(5.87 ± 1.09)d,(5.75 ±1.34)d and (5.72 ± 1.51)d vs.(6.68 ± 1.60)d,(7.25 ± 1.37)d and (7.16±1.48)d vs.(8.10±l.47)d,Z=-2.498,-2.469,-2.359,-2.213 and-2.982,-2.405,-2.373,-2.222,P ＜0.05,or P ＜0.01)].There were no significant differences in the Lowell score,the length of time of cough,wheeze,lung rales disappears and the length of hospital stay between the observation group A and observation groupB[(5.81 ± 1.53) points vs.(5.85 ± 1.37) points,(4.75 ± 1.34) points vs.(4.72 ±1.30) points,(3.19± 1.15) points vs.(3.22 ± 1.16) points,(6.63 ± 1.41) d vs.(6.56 ± 1.37) d,(5.19 ±1.03)d vs.(5.25 ± 1.05)d,(5.75 ± 1.34) d vs.(5.72 ± 1.51) d,(7.25 ± 1.37) d vs.(7.16 ± 1.48) d,Z =-0.164,-0.021,-0.140,-0.295,-0.167,-0.374,-0.233,all P ＞ 0.05].Children in three groups had no serious adverse events (all P ＞ 0.05).Conclusion Nebulized hypertonic saline in the treatment of bronchiolitis can relieve symptoms and signs,shorten the hospitalization time,and has less adverse reaction,it is worthy of clinical use.

Efficacy of minimally invasive percutaneous intervertebral disc approach for treatment of sympathet-ic cervical spondylosis / 中华麻醉学杂志

Objective To evaluate the efficacy of minimally invasive percutaneous intervertebral disc approach for treatment of sympathetic cervical spondylosis. Methods Fifty?six patients diagnosed as having sympathetic cervical spondylosis from January 2009 to August 2014, aged 22-64 yr, with the dis?ease course ranged from 6 months to 15 yr and a follow?up period of 6 months, were enrolled in the study. The related minimally invasive approach was selected according to the height of the diseased intervertebral space. When the ratio of the height of diseased intervertebral space∕normal intervertebral space≤1∕3, per?cutaneous radiofrequency ablation was used ( groupⅠ, n=19); when the ratio within the range of 1∕3-2∕3, percutaneous laser disk decompression was used ( groupⅡ, n=12); when the ratio≥2∕3, low?tem?perature plasma radiofrequency ablation was used ( group Ⅲ, n=25) . Before operation, at 2 weeks after operation, and at 1, 3 and 6 months after operation, the sympathetic symptoms were evaluated using the 20?point score. At 2 weeks and 6 months after operation, the patients′ subjective satisfaction was assessed and graded ( excellent, good, medium and poor ) . Results All the patients were followed up for 6 months. The sympathetic symptom scores were significantly lower at each time point after operation in Ⅰand Ⅲ groups and at 2 weeks and 3 and 6 months after operation in group Ⅱ than those before operation ( P<0.05) . The excellent and good rate of patients′subjective satisfaction was 67.9% at 2 weeks after op?eration, and 76.8% in the last follow?up period at 6 months after operation. Conclusion The minimally invasive percutaneous intervertebral disc approach has a marked short?term effect on sympathetic cervical spondylosis.

Folic acid magnetic nanoparticles containing cisplatin inhibit the growth of human laryngeal cancer Hep-2 cells in a non-cytotoxic manner / 中国组织工程研究

BACKGROUND: Chemotherapy drugs can kil both cancer cel s and normal tissue cel s. Molecular targeted therapy can reduce or avoid toxicity of chemotherapy drugs to normal cel s. OBJECTIVE: To study the therapeutic effect of folic acid magnetic nanoparticles containing cisplatin on laryngeal cancer. METHODS: Folic acid-cis-diaminodichloroplatinum (II)-aldehyde sodium alginate-magnetic nanoparticles (FA-CDDP-ASA-MNPs) were prepared. The FA-CDDP-ASA-MNPs, CDDP and FA-ASA-MNPs were cultured together with human laryngeal cancer Hep-2 cel s. To detect the effect of FA-CDDP-ASA-MNPs, CDDP and FA-ASA-MNPs on human laryngeal cancer Hep-2 cel s, MTT, flow cytometry and transmission electron microscopy examination were used in vitro. RESULTS AND CONCLUSION: Both FA-CDDP-ASA-MNPs and CDDP could inhibit the growth of human laryngeal cancer Hep-2 cel s, and there was no difference in their inhibitory rates (P > 0.05). FA-CDDP-ASA-MNPs and CDDP showed increased inhibitory rates of human laryngeal cancer Hep-2 cel s with the increase of CDPP concentration. The half maximal inhibitory concentrations of CDDP for inhibiting Hep-2 cel s were significantly different at 24 and 48 hours after culture (P 0.05). FA-CDDP-ASA-MNPs and CDDP at low concentrations could increase the percentage of cel s at G0/G1, but decrease the cel proportion at S and G2/M phases (P < 0.05). Under transmission electron microscope, Hep-2 cel s with the intake of FA-CDDP-ASA-MNPs appeared to have notable apoptosis. These findings suggest that folic acid magnetic nanoparticles containing cisplatin can inhibit the growth of human laryngeal cancer Hep 2 cel s, with no influence on the efficacy of cisplatin and with no cytotoxic effect.

Primary benign paroxysmal positional vertigo vestibular detection of evoked myogenic potential significance / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the clinical significance of ocular vestibular evoked myogenic potentials (oVEMP) and cervical vestibular evoked myogenic potentials (cVEMP) in primary unilateral benign paroxysmal positional vertigo (BPPV).@*METHOD@#Fifty-two patients with unilateral primary BPPV (BPPV group) and 38 normal subjects (control group) received ocular vestibular evoked myogenic potential (oVEMP) and cervical vestibular evoked myogenic potential (cVEMP) test using tone burst stimuli. The response rate, latency and amplitude were analyzed.@*RESULT@#In BPPV group, the response rate of oVEMP was 46.15% in lesioned side and 48.08% in healthy side, respectively. The response rate of cVEMP was 67.31% in lesioned side and 65.38% in healthy side, respectively. In control group, the response rate on the left ear was 84.21% for oVEMP and 92.11% for cVEMP. On the right ear, was 81.58% for oVEMP and 94.74% for cVEMP in control group, there was no significant difference in cVEMP and oVEMP P1, N1 N1-P1 latency and amplitude between left and right ear. The interaural amplitude ratio and asymmetry of cVEMP and oVEMP was significantly different between BPPV group and control group (P<0.05).@*CONCLUSION@#Unilateral primary BPPV with bilateral impaired vestibular otolith pathways function can be objectively evaluated by oVEMP and cVEMP detection. Abnormal oVEMP responses were more frequently detected than cVEMP.

Meta analysis for the effect of clinical pathways on single disease management / 中华医院管理杂志

Objective To analyze the effect of clinical pathways on single disease management.Methods Clinical controlled trials on tumors of uterine,benign biliary tract diseases and benign thyroid neoplasm were collected and related literatures were screened according to the criteria of inclusion.The literature so collected underwent a Meta analysis.Results A total of 21 literatures were included.Meta analysis indicated that statistical difference existed in the total cost of hospitalization(WMD=1046.06,95％CI:- 1281.15 ～ - 810.96,P＜0.00001) and length of hospital stay (WMD=- 2.18,95％CI:-2.59～- 1.76,P＜0.00001)between non-clinical pathways group and clinical pathways group.Conclusion Implementation of clinical pathways can further reduce hospital costs and shorten hospital days of the single disease management.

Study on the practicality of building a performance evaluation system in Beijing Chao-Yang Hospital / 中华医院管理杂志

The paper introduced the hospital's attempt to build a scientific and practical set of performance evaluation system based on KPI.The system determines the quantitative indicators for the efficiency and performance of each department,and effectively helps accomplish common objectives of the hospital and its departments,playing a key role in the sustaimble development of the hospital.

Efficacy of percutaneous laser disc decompression combined with injection of collagenase through a target location for treatment of lumbar intervertebral disc protrusion / 中华麻醉学杂志

Objective To investigate the efficacy of percutaneous laser disc decompression(PLDD)combined with injection of collagenase through a target location for treatment of lumbar intervertebral disc protrusion.Methods Ninety patients with lumbar intervertebral disc protrusion scheduled for discolysis,aged 31-52 yr,weighing 58-70 kg,were randomly divided into 3 groups: PLDD group(group P,n = 29),collagenase injection group(group C,n = 31),PLDD combined with injection of collagenase through a target location group(group PC,n = 30).The puncture was performed under the guidance of CT.Group P was treated using PLDD.Group C was treated with collagenase injection.Group PC was treated with injection of collagenase after PLDD was completed.The therapeutic effect was assessed before operation and on day 7,30,60 and 90 after operation using M-JOA score.Results M-JOA grade was significantly higher at the each time point after operation in group P and PC,and on day 30,60 and 90 after operation in group C than that before operation(P ＜ 0.05).M-JOA grade was significantly lower on day 30 after operation in group P,while higher on day 30,60 and 90 after operation in group C and PC than that on day 7 after operation(P ＜ 0.05).M-JOA grade was significantly lower at the each time point after operation in group P and C than in group PC.Conclusion The therapeutic effect of PLDD combined with collagenase injection through a target location is stable for treatment of lumbar intervertebral disc herniation and better than that of PLDD or collagenase injection alone.

Application of Cisatracurium in Hiatal Hernia Repair of Newborn / 中国药房

OBJECTIVE: Approach to the pharmacodynamics of cisatracurium in newborn. METHODS: Sixty patients were randomized to two groups: Group Ⅰ and Group Ⅱ , received( iv) 2ED95 or 3ED95 cisatracurium in 5 seconds respectively, n=30. Neuromuscular transmission was monitored and Intubation conditions were assessed at 120s after cisatracurium administration using a 4- part scale. Observe onset time, TOF no reaction period, duration of action, recovery index, duration in vivo. RESULTS: The muscular blockage and conditions of intubation after 120s were different between two groups( P0. 05) . CONCLUSIONS: 3ED95 cisatracurium produces quicker, safer onset time and acceptable intubating conditions in the great majority of newborn than 2ED95. The TOF no reaction period, duration of action and duration in vivo were longer in 3ED95 group than in 2ED95 group, but recovery index are no significant between 2 groups with dosage.