Comprehensive evaluation and analysis of laboratory resource allocation in 14 blood stations based on entropy weight -TOPSIS method / 中国输血杂志

【Objective】 To investigate the resource allocation status of blood testing laboratories in 14 blood stations in Gansu Province, explore the impact of differences in basic conditions on the comprehensive testing ability of laboratories, so as to promote the homogenization and standardization of blood screening capacity in blood stations in Gansu and improve blood safety and effectivenes. 【Methods】 An evaluation index system of laboratory resource allocation was constructed and a question-naire was designed. The data of human resources, infrastructure and key equipment of 14 blood stations were collected. The entropy weight -TOPSIS method was used to evaluate and rank the resource allocation of 14 blood stations. 【Results】 In the comprehensive evaluation of blood testing laboratory resource allocation in 14 blood stations in Gansu, the top three were laboratories A, B and I, and the last three were laboratories G, M and J. On the whole, the main issue was unreasonable structure of human resources: most laboratories had unreasonable age structure; except for Laboratory A, there was no personnel with bachelor's degree or above in laboratories; most laboratories had not established a team with intermediate professional titles. In terms of infrastructure, the size of seven laboratories could not meet the needs of modern laboratory testing, and all eight blood stations had no spare nucleic acid laboratories nor a mutual spare laboratory with other blood stations As for the key equipment, 5 laboratories had no automatic blood grouping diagnostic instrument, 5 laboratories only had one set of enzyme immunoassay detection system, 3 laboratories had no spare equipment for the key equipment, which means if the equipment failure could not be repaired in time, the release of results would be affected. 【Conclusion】 There were significant differences in human resources, infrastructure and key equipment of blood testing laboratories in 14 blood stations in Gansu, which had a great impact on laboratory testing capacity and subsequent development. It is suggested that governments at all levels and health administrative departments optimize the input of laboratory resource allocation according to the blood collection volume of blood stations to gradually narrow the differences in resource distribution between different regions, improve the degree of laboratory automation and optimize the personnel structure, so as to build high-quality and efficient blood testing laboratories and ensure the safety of clinical blood use.

Design and development of nursing care planning section of clinical decision support system / 中国实用护理杂志

Objective:To provide reference for the development of a more intelligent and systematic nursing clinical decision support system based on the concept of precision nursing and data sharing, the nursing plan module of clinical decision support system.Methods:An evidence-based knowledge base was constructed based on the nursing process and the standardized nursing terminologies; the nursing plan module was designed according to clinical needs, and the logical reasoning rules were formulated from the generation, sequencing and stopping of nursing problems, objectives, measures and activities, and finally the nursing plan module of clinical decision support system was formed.Results:The nursing plan module of clinical decision support system included the basic information of patients, positive evaluation items and weight values, nursing problems, objectives, measures and activities, etc. the module could automatically deduce the nursing plan according to the patient's individual characteristic index (positive evaluation item), and sort the nursing problems and corresponding measures and activities according to the generation time, weight value and correlation degree. It could automatically distinguish nursing problems, goals, measures and the time of activity stop, and realize intelligent decision-making.Conclusion:The interface of nursing plan module of this system is clear and logical reasoning rules are rigorous. It breaks through the bottleneck of nursing decision-making based on personal professional knowledge and experience in clinical situation for a long time, which can ensure the homogeneity of nursing plan and improve the correctness of decision-making.

Clinical study of Chinese medical chiropractic for the children with cough variant asthma and qi deficiency of spleen and lung syndrome / 国际中医中药杂志

Objective:To evaluate the clinical effect of Chinese medical chiropractic in treating children with cough variant asthma syndrome (CVA) of Lung-Spleen Qi Deficiency.Methods:From October 2017 to October 2018, 60 CVA children with syndrome of lung-spleen qi deficiency were enrolled from pediatric outpatient department of Maoming Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, and they were randomly divided into the control group and observation group by random number table method, with 30 in each group. The control group was given montelukast sodium granules orally on the basis of conventional treatment, and the observation group was given chiropractic treatment on the basis of the control group. Both groups were treated for 6 weeks and followed up for 2 months. The TCM syndrome scores were performed before and after treatment, and the changes of serum IgA, IgG, IgM and IgE were detected by ELISA. The recurrence was observed and recorded during the follow-up period, and the clinical effect rate was evaluated.Results:The total effect rates of the observation group and the control group were 86.7% (26/30) and 56.7% (17/30), respectively, with significant differences between the two groups ( χ2=6.648, P=0.008). After treatment, the scores of cough, sputum volume, oppression in chest, tongue coating, concomitant symptoms and total scores in the observation group were significantly lower than those in the control group ( t values were 2.639, 2.628, 2.633, 2.627, 2.725, 2.642, respectively, all Ps<0.05). After treatment, the IgA [(2.31 ± 1.20) g/L vs. (1.55 ± 0.72) g/L, t=2.635], IgG [(11.16 ± 3.39) g/L vs. (8.18 ± 3.27) g/L, t=2.751], IgM [(1.72 ± 0.34) g/L vs. (1.27 ± 0.36) g/L, t=2.660] in the observation group were significantly higher than those in the control group ( P<0.05), while the IgE [(51.32 ± 32.62) g/L vs. (74.58 ± 40.77) g/L, t=2.619] in the observation group were significantly lower than those in the control group ( P<0.05). During the follow-up, the recurrence rate was 19.2% (5/26) in the observation group and 70.6% (12/17) in the control group, and the difference between the two groups was statistically significant ( χ2=4.675, P=0.029). Conclusion:Chinese medicine chiropractic can improve the clinical symptoms and serum immune factor levels of children with cough variant asthma syndrome of lung and spleen qi deficiency, reduce the recurrence rate, and improve the clinical efficacy.

Application of individual head-rest combined with thermoplastic fixation mask in position fixation for irradiation with helical tomotherapy for head and neck tumors / 中国基层医药

Objective:To compare the positioning errors of individual head-rest combined with thermoplastic fixation mask versus thermoplastic fixation mask alone in patients with head and neck tumors. Methods:Twenty-eight patients who received irradiation with helical tomotherapy in Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) between October 2019 and April 2020 were included in this study. They were randomly assigned to receive position fixation with either individual head-rest combined with thermoplastic fixation mask (N1 group, n = 14) or thermoplastic fixation mask alone (N2 group, n = 14). Megavoltage computed tomography (MVCT) scanning registration was used to obtain the positioning errors in translation and rotation (ROLL) in the left-right (X), head-food (Y), and belly-back (Z) directions. There were a total of 841 CT scans, consisting of 425 scans in group N1 and 416 scans in group N2. Results:The positioning errors in X, Y, Z and ROLL directions in the N1 group were (1.37 ± 1.04) mm, (1.38 ± 1.12) mm, (1.47 ± 1.62) mm and (1.47 ± 1.62) ° respectively, and they were (1.57 ± 1.21) mm, (2.10 ± 1.51) mm, (1.61 ± 1.50) mm and (1.40 ± 1.30) ° respectively in the N2 group. There was significant difference in positioning errors in the Y direction between N1 and N2 groups ( P = 0.013). In the N1 group, the outward expansion boundaries in X, Y and Z directions was 4.15 mm, 4.23 mm and 4.81 mm respectively, and it was 4.77, 6.31 and 5.08 mm, respectively in the N2 group. In the X direction, there was significant difference in positioning errors taking 3 mm as the dividing point between N1 and N2 groups ( χ2 = 10.516, P < 0.001). In the Y direction, there was significant difference in positioning errors taking 1, 2 and 3 mm as the dividing points between N1 and N2 groups ( χ2 = 24.889, P < 0.001; χ2 = 42.202, P < 0.001; χ2 = 46.204, P < 0.001). In the Z direction, there was significant difference in positioning errors taking 2 mm as the dividing point between N1 and N2 groups ( χ2 = 7.335, P = 0.007). In the N1 group, the percentage of positioning errors < 3 mm in the X, Y and Z directions was 92%, 90% and 92%, respectively. Conclusion:Compared with thermoplastic fixation mask alone, individual head-rest combined with thermoplastic fixation mask can better effectively improve the positioning stability and reduce positioning errors in patients receiving irradiation with helical tomotherapy for head and neck tumors. The combined method is of certain innovation.

Clinical application of new type individualized fixation device for radiotherapy of rectal cancer / 中国基层医药

Objective To explore the clinical effect of new type rectal cancer radiotherapy individualized fixation device in the radiotherapy of rectal cancer. Methods From June 2015 to December 2016,60 patients with rectal cancer who accepted the external irradiation in Zhejiang Tumor Hospital were divided into two groups by random number table method. A group(31 cases) received new type rectal cancer radiotherapy position fixation devices with thermoplastic film. B group(29 cases) received simple foam pad with thermoplastic film. Before each treatment,Cone beam CT(CBCT) scan was conducted. The applied CBCT image and the planned reconstruction image were compared in the direction of X(left and right),Y(upper and lower)and Z(front and rear) axis. The setup error was recorded, and the correlation between the two groups was analyzed. Results The average setup error of patients in A group in X (left and right),Y(upper and lower),Z(front and rear) axis were (1. 61 ± 0. 18)mm,(1. 82 ± 0. 13)mm,(1. 91 ± 0. 11)mm,respectively. The average setup error of patients in B group in X(left and right),Y(upper and lower),Z (front and rear) axis were (2. 22 ± 0. 13)mm,(2. 43 ± 0. 14)mm,(2. 36 ± 0. 13)mm,respectively. There were statistically significant differences between the two groups(t=14. 958,17. 501,11. 283,all P＜0. 001). Conclusion The new type of rectal cancer radiotherapy position fixing device is more comfortable than the simple foam pad,and the setting error is smaller than the simple foam pad.

Expressions of peroxisome proliferator-activated receptor γ, retinoic acid X receptor α and cyclooxygenase 2 in cervical squamous cell carcinoma and their significances / 肿瘤研究与临床

Objective To study the functions of peroxisome proliferator-activated receptorγ(PPARγ), retinoic acid X receptor α (RXRα) and cyclooxygenase 2 (COX-2) in the carcinogenesis of cervical squamous cell carcinoma (SCC). Methods The expressions of PPARγ, RXRα and COX-2 in 17 cases of normal cervical epithelium (NCE), 72 cases of squamous intraepithelial lesion (SIL) and 42 cases of cervical SCC were detected with immunohistochemical method respectively. Results The positive expression rates of PPARγ in the NCE, SIL and cervical SCC group were 23.5 % (4/17), 58.3 % (42/72) and 83.3 % (35/42) respectively; the positive expression rates of RXRα in the NCE, SIL and cervical SCC group were 29.4 %(5/17), 54.2 % (39/72) and 90.5 % (38/42) respectively. No significant expression of COX-2 was found in the NCE, while the positive expression rates of COX-2 in SIL and cervical SCC were 36.1 % (26/72) and 57.1 %(24/42) respectively. The positive expression rates of PPARγ, RXRαand COX-2 in high-grade SIL group were higher than those in low-grade SIL group (all P<0.05). In cervical SCC group, the positive expression rate of COX-2 with lymph node metastasis was higher than that without lymph node metastasis (χ2= 3.98, P= 0.04). Conclusion PPARγ, RXRαand COX-2 might be all involved in the carcinogenesis of SCC.

Expressions of peroxisome proliferator-activated receptor γ, retinoic acid X receptor α and cyclooxygenase 2 in cervical squamous cell carcinoma and their significances / 肿瘤研究与临床

Objective To study the functions of peroxisome proliferator-activated receptorγ(PPARγ), retinoic acid X receptor α (RXRα) and cyclooxygenase 2 (COX-2) in the carcinogenesis of cervical squamous cell carcinoma (SCC). Methods The expressions of PPARγ, RXRα and COX-2 in 17 cases of normal cervical epithelium (NCE), 72 cases of squamous intraepithelial lesion (SIL) and 42 cases of cervical SCC were detected with immunohistochemical method respectively. Results The positive expression rates of PPARγ in the NCE, SIL and cervical SCC group were 23.5 % (4/17), 58.3 % (42/72) and 83.3 % (35/42) respectively; the positive expression rates of RXRα in the NCE, SIL and cervical SCC group were 29.4 %(5/17), 54.2 % (39/72) and 90.5 % (38/42) respectively. No significant expression of COX-2 was found in the NCE, while the positive expression rates of COX-2 in SIL and cervical SCC were 36.1 % (26/72) and 57.1 %(24/42) respectively. The positive expression rates of PPARγ, RXRαand COX-2 in high-grade SIL group were higher than those in low-grade SIL group (all P<0.05). In cervical SCC group, the positive expression rate of COX-2 with lymph node metastasis was higher than that without lymph node metastasis (χ2= 3.98, P= 0.04). Conclusion PPARγ, RXRαand COX-2 might be all involved in the carcinogenesis of SCC.

Application of circulating DNA in colorectal cancer / 国际肿瘤学杂志

Circulating DNA is defined as a kind of extracellular DNA that exists in plasma,cerebrospinal fluid and synovial fluid.The concentration of circulating DNA of cancer patients is significantly higher than that in healthy people.The genetic and epigenetic alterations of circulating cell-free nucleic acids are relevant to cancer development and progression,for example,gene mutation,DNA methylation and microsatellite instability and so on.The quantitative and qualitative detection of circulating DNA shows promising potential value in cancer screening,diagnosis,disease monitoring treatment and prognosis.

Analysis on set-up errors of position fixation with simple perforated foam pad in colorectal cancer radio-therapy / 中国基层医药

Objective To explore the set-up errors of position fixation with simple perforated foam pad in colorectal cancer radiotherapy and their causes as well as the improvement measures.Methods Sixty cases of color-ectal cancer patients undergoing radiotherapy were collected.Prone position was adopted with the position fixed by perforated foam pad and membrane.CBCT imaging was taken weekly before treatment,setup errors were corrected if necessary.Errors throughout the course of treatment for each patient were recorded and compared between patients, followed by analyzing the reasons of errors.Results Before calibration,the maximum errors on the direction of left and right (X-axis),front and back (Z),upside and downside (Y)in these 60 patients were 0.5cm,0.9cm and 0.7cm respectively with the average errors of (0.22 ±0.03)cm,(0.38 ±0.03)cm and (0.27 ±0.04)cm respec-tively.Conclusion The method of applying perforated foam pad and thermoplastic mask in colorectal cancer radio-therapy is currently the most commonly used in the clinical position fixation techniques,by which the small intestine, bladder and other pelvic tissues can be well protected.Due to poor comfort prone position,it is necessary to further improve perforated foam pad through improving the quality of the foam pad,thus improving patients comfort and posi-tioning repeatability and reducing position fixation errors.

Joint Technical Innovation of Pharmaceutical Industry in China / 中国药房

OBJECTIVE:To give some information for the strategy of joint technical innovation in our country.METHODS:To analyse the real situation of joint technical innovation in China and to summarize the experiences of international pharmaceutical corporations.RESULTS & CONCLUSION:Joint technical innovation is the general trend of development,we should take measures according to the existing problems in Chinese pharmaceutical industry.