Evaluation of the safety and efficacy of mitomycin C-perfluorooctyl bromide liposome nanoparticles in the treatment of human pterygium fibroblasts / 眼科新进展

Objective To prepare a nano drug(PFOB@Lip-MMC)with liposome as the carrier,liquid perfluorooc-tyl bromide(PFOB)as core and mitomycin C(MMC)loading on the liposome shell and study its inhibitory effect on the proliferation of human pterygium fibroblasts(HPFs).Methods The thin film dispersion-hydration ultrasonic method was used to prepare PFOB@Lip-MMC and detect its physical and chemical properties.Cell Counting Kit-8,Cam-PI cell viability staining and flow cytometry were employed to detect the impact of different concentrations of PFOB@Lip-MMC on the via-bility of HPFs.DiI fluorescence labeled PFOB@Lip-MMC was used to observe the permeability of the nano drug to HPFs under a laser confocal microscope.After establishing HPF inflammatory cell models,they were divided into the control group(with sterile phosphate-buffered saline solution added),PFOB@Lip group(with PFOB@Lip added),MMC group(with MMC added),PFOB@Lip-MMC group(with PFOB@Lip-MMC added)and normal group(with fresh culture medi-um added)according to the experimental requirements.After co-incubation for 24 h,flow cytometer was used to detect the apoptosis rate of inflammatory cells,and the gene expression levels of interleukin(IL)-1β,prostaglandin E2(PGE2),tumor necrosis factor(TNF)-α and vascular endothelial growth factor(VEGF)in cells were analyzed by PCR.Results The average particle size and Zeta potential of PFOB@Lip-MMC were(103.45±2.17)nm and(27.34±1.03)mV,respec-tively,and its entrapped efficiency and drug loading rate were(72.85±3.28)％and(34.27±2.04)％,respectively.The sustained-release MMC of drug-loaded nanospheres reached(78.34±2.92)％in vitro in a 24-hour ocular surface environ-ment.The biological safety of PFOB@Lip-MMC significantly improved compared to MMC.In terms of the DiI fluorescence labeled PFOB@Lip-MMC,after co-incubation with inflammatory HPFs for 2 h,DiI fluorescence labeling was diffusely dis-tributed in the cytoplasm of inflammatory HPFs.The apoptosis rate of inflammatory HPFs in the PFOB@Lip-MMC group[(77.23±4.93)％]was significantly higher than that in the MMC group[(51.62±3.28)％].The PCR examination results showed that the gene transcription levels of IL-1 β,PGE2,TNF-α and VEGF in other groups were significantly reduced com-pared to the control group and PFOB@Lip group,with the most significant decrease in the PFOB@Lip-MMC group(all P＜0.05).Conclusion In this study,a novel nano drug(PFOB@LIP-MMC)that inhibited the proliferation of HPFs was successfully synthesized,and its cytotoxicity was significantly reduced compared to the original drugs.It has good bio-compatibility and anti-inflammatory effects,providing a new treatment approach for reducing the recurrence rate after pte-rygium surgery.

Effects of cold spray on pain after non-coring needle insertion into totally implantable access port / 中华临床营养杂志

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.

Analysis on the application and effect of time-sharing appointment in the peripherally inserted central catheter maintenance clinic / 中华临床营养杂志

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.

An investigation of nurses′ knowledge, attitude and behavior status about the safety management of enteral nutrition tube among nurses / 中华临床营养杂志

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.

Multicenter survey on nurses' knowledge and attitude on common complications among bedridden patients in Chinese hospitals / 中华护理杂志

Objective To investigate the knowledge and attitude of nurses on prevention and intervention of common complications among bedridden patients in Chinese hospitals and to explore the influential factors.Methods It was a cross-sectional study.A total of 3 903 nurses from 6 tertiary hospitals,11 secondary hospitals and 8 primary hospitals from 6 provinces and cities were recruited by convenience sampling and surveyed using selfdesigned questionnaires.Results Nurses' average scoring rate of knowledge and attitude were 73.46％ and 85.02％.Level of hospitals,whether in ICU or not,age,working time,educational background,job title,position,employment form were influential factors for nurses' knowledge (P＜0.05).Meanwhile,level of hospitals,educational background,position,employment form were influential factors for nurses' attitude (P＜0.05).Conclusion Nurses took a positive attitude for prevention and intervention of common complications among bedridden patients,while the level of nurses' knowledge should be improved.

Under the Background of the New Media Era Survey and Discussion on Medical Students′Cognitive Differences Between the Doctor-Patient Relationship / 中国医学伦理学

Objective:To learn about the medical students’ cognitive status between the doctor-patient rela-tionship, In order to provide scientific decision basis on the reform of medical humanities education. Methods:In this paper, self-designed questionnaire by using cluster random sampling methods ,the analysis of Gannan medical college medical students’doctor-patient relationship cognitive status. Results:35. 1% of the students think that doctor-patient relationship is a harmonious;89 . 6% medical students thought that the nature of the doctor-pa-tient relationship is a consumer economy relationship;57 . 1% medical students think that should be taken toset-tle way to solve the doctor-patient conflicts;25 . 1% medical students think doctor-patient conflicts affect the graduate employment orientation in the future. Conclusion:There has significant difference in the medical students′awareness of the doctor-patient relationship, we should further strengthen the medical students medical cognitive education, cultivate the medical students′correct values of doctor-patient.