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Objective@#To investigate the effect of FOCUS(F:find; O:organize; C:clarify; U:understand; S:select)-PDCA on reducing the adverse event rate caused by junior nurses.@*Methods@#A historical control design was used, traditional method to manage adverse events among junior nurses from January to June 2017. Interdisciplinary team combined with FOCUS-PDCA courses was established from July to December 2017. In the course problems were found and analyzed, the present procedures and standard were issued and improved. And these data were summarized and analyzed to improve the quality of management continuously.@*Results@#Before applying the FOCUS-PDCA model, the total incidence of adverse events caused by junior nurses, bachelor′s degree or above, nurse practitioners, and working career of 1-3 years were respectively as follows: 42.66%(285/668), 46.67%(112/240), 40.54%(105/259), 51.61%(176/341). After using this model, the above four indicators were 33.04%(229/693), 33.33%(84/252), 27.04%(73/270), 38.97%(136/349) respectively. There were significant differences before and after the FOCUS-PDCA (χ2=4.20-13.39, P<0.01 or 0.05).@*Conclusions@#Multidisciplinary team-based FOCUS-PDCA management reduces the adverse event rate caused by junior nurses and improves the quality of management continuously.
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Objective:To study antenatal immunity test and outcomes of Rh-negative pregnant women.Methods:287cases(1.25％ in 22880 cases)of Rh-negative pregnant women delivered in Shanghai Sixth People hospital from January 1 st,2010 to December 31,2016 were retrospectively analyzed.Rh(D) blood group was identified by a micro column gel method,and the same as serum anti-D antibody.The Rh phenotype detection was done Serology method and the hemolytic disease of the newborn was used indirect antiglobulin test,serum free antibody test,absorption and elution test.Some Rh negative pregnant women were implemented autologous blood at 37 weeks of gestation.Results:Among 287 cases of Rh-negative,12 cases had anti-D antibody and the positive rate was 4.18％.Among the 12 cases of anti-D positive,their Rh phenotype were all ccdee and they all had history of childbearing.In 90 cases which had one history of birth,there were ten cases had anti-D antibody (11.11％),in 15 cases which had two history of birth,there were two cases had anti-D antibody(13.33％).287 Rh negative pregnant women had 290 child births,among which 8 newborn had neonatal hemolytic disease,the incidence rate was 2.75％ (8/290).In the 12 cases of anti-D positive,there were 1 case died because of fetal neonatal hemolytic disease and 7 cases were cured and 4 cases were normal with free of jaundice symptoms.There were 146 pregnant women implementation of autologous donation safely.According to the delivery way of childbirth,287 cases were divided by cesarean section and vaginal delivery,comparing postpartum haemorrhage amount with autologous donantion and unautologous donation,respectively,the result showed that they had no significant difference(P ＞0.05).Conclusions:It should be pay attention to the pregnant women who had childbearing history and whose Rh phenotype is ccee,which tend to produce anti-D immune antibody.However,this does not necessarily lead to hemolytic disease.Based on maternal and fetus conditions,autologous donation is safe and valuable in Rh-negative pregnant.
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Objective To evaluate the effect of miR‐335 regulate cell proliferation by targeting survivin in breast cancer cells MCF‐7 .Methods (1)Chose breast cancer tissue and para‐carcinoma tissue ,and used RT‐PCR or Western blot to detect the expres‐sion of miR‐335 and survivin protein .(2)Chose breast cancer cells MCF‐7 ,respectively transfected miR‐335 mimic and mimic con‐trol .The expression of miR‐335 and survivin protein were detected by RT‐PCR or Western blot .(3)Chose breast cancer cells MCF‐7 ,respectively co‐transfection wild type survivin 3′‐UTR(survivin‐wt)or mutant type urvivin 3′‐UTR(survivin‐Mut)and miR‐335 mimic or negative control(NC)to breast cancer cells MCF‐7 .The cell luciferase activity were detected by dual‐luciferase report gene experiment .(4)Chose breast cancer cells MCF‐7 ,respectively transfected mimic control ,miR‐335 mimic and miR‐335 mimic+ sur‐vivin .The cell proliferation activity of each group were detected by MTT method .Results (1)Compared with para‐carcinoma tis‐sue ,the miR‐335 expression of breast cancer tissue significantly decreased(P0 .05) .(4)Compared with transfection mimic control ,the MCF‐7 proliferative activity significantly decreased after transfection miR‐335mimic(P<0 .05) .Compared with transfection miR‐335 mimic ,the MCF‐7 proliferative activity signifi‐cantly increased after transfection miR‐335 mimic+survivin(P<0 .05) ,but still lower than transfection mimic control(P<0 .05) . Conclusion In breast cancer tissue ,the miR‐335 show low expression ,and survivin show high expression .miR‐335 can target sur‐vivin to inhibit the proliferation activity of breast cancer cells MCF‐7 .
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Matrix_assisted laser desorption ionization_time of flight tandem mass spectrometry ( MALDI_TOF/TOF MS) and electrospray ionization_quadrupole_time of flight mass spectrometry ( ESI_Q_TOF MS) were used to confirm the structure of cyclic lipopeptide daptomycin fastly. First, the relative molecular weight 1916. 7107 of daptomycin was measured by ESI with error 0. 0007. The sample’s doubly charged peak m/z 809. 848 was selected as precursor ion for ESI_MS/MS analysis, and the exocyclic amino acid sequence C9 H19 CO_Trp_Asn_Asp was successfully matched. Second, the experimental conditions of cleaving daptomycin by lithium hydroxide ( LiOH) were optimized and the ring_opened process was monitored by MALDI_TOF/TOF MS. After obtaining ring_opened product with purity of above 95%, the MS/MS measurements by MALDI and ESI were carried out. The b+and y+of ring_opened product were completely matched, which confirmed the amino acid sequence of daptomycin. Finally, ESI_MS/MS conditions of ring_opened product were further optimized to obtain more low mass fragment ions for analyzing the structure of fatty acid chain and the cleavage pattern of fat chain in mass spectrometry was proposed. The method was fast, convenient, accurate and reliable for identifying cyclic lipopeptide compounds.
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BACKGROUND:Titanium aloy and stainless steel are two common internal fixation materials, but there are some difference in their therapeutic effects and biocompatibility. OBJECTIVE:To explore the therapeutic effects and biocompatibility of titanium aloy and stainless steel internal fixation materials for the treatment of spinal tuberculosis. METHODS:Seventy-one spinal tuberculosis patients, 35 males and 36 females, aged 17-81 were enroled. Among them, 35 patients received titanium aloy internal fixation, and the 36 patients underwent stainless steel internal fixation. At the end of 12-month folow-up, Cobb angle changes, therapeutic effect and Frankel grade were analyzed in the two groups. RESULTS AND CONCLUSION:Before treatment, there was no difference in the spinal kyphosis angle and Frankel grade between the two groups. At the last folow-up, the Frankel grade and Cobb angle were both improved in the two groups (P < 0.05), but there was stil no difference between the two groups. The cure rate was 97% (n=34) in the titanium aloy group and 92% in the stainless steel group (n=33), and no significant difference was found between the two groups. These two kinds of internal fixation materials exhibited good biocompatibility, and no infection and other adverse reactions occurred. These findings indicate that both titanium aloy and stainless steel as internal fixation materials have good biocompatibility and therapeutic effects.
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In women with preeclampsia (PE), endothelial cell (EC) dysfunction can lead to altered secretion of paracrine factors that induce peripheral vasoconstriction and proteinuria. This study examined the hypothesis that PE sera may directly or indirectly, through human umbilical vein ECs (HUVECs), stimulate phospholipase C-gamma1-1,4,5-trisphosphate (PLC-gamma1-IP3) signaling, thereby increasing protein kinase C-alpha (PKC-alpha) activity, collagen I expression and intracellular Ca2+ concentrations ([Ca2+]i) in human umbilical artery smooth muscle cells (HUASMCs). HUASMCs and HUVECs were cocultured with normal or PE sera before PLC-gamma1 silencing. Increased PLC-gamma1 and IP3 receptor (IP3R) phosphorylation was observed in cocultured HUASMCs stimulated with PE sera (P<0.05). In addition, PE serum significantly increased HUASMC viability and reduced their apoptosis (P<0.05); these effects were abrogated with PLC-gamma1 silencing. Compared with normal sera, PE sera increased [Ca2+]i in cocultured HUASMCs (P<0.05), which was inhibited by PLC-gamma1 and IP3R silencing. Finally, PE sera-induced PKC-alpha activity and collagen I expression was inhibited by PLC-gamma1 small interfering RNA (siRNA) (P<0.05). These results suggest that vasoactive substances in the PE serum may induce deposition in the extracellular matrix through the activation of PLC-gamma1, which may in turn result in thickening and hardening of the placental vascular wall, placental blood supply shortage, fetal hypoxia-ischemia and intrauterine growth retardation or intrauterine fetal death. PE sera increased [Ca2+]i and induced PKC-alpha activation and collagen I expression in cocultured HUASMCs via the PLC-gamma1 pathway.
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Adult , Female , Humans , Pregnancy , Young Adult , Apoptosis , Calcium/metabolism , Cell Line , Cell Survival , Cells, Cultured , Coculture Techniques , Collagen Type I/analysis , Human Umbilical Vein Endothelial Cells , Muscle, Smooth, Vascular/cytology , Phospholipase C gamma/genetics , Pre-Eclampsia/blood , Protein Kinase C-alpha/metabolism , RNA Interference , Signal TransductionABSTRACT
Objective To analyze the effect of psychological intervention and intraoperative operation cooperation on cesarean de-livery outcome of pregnant women with heart disease .Methods 60 cases of pregnant women complicating heart disease in this hos-pital from July 2010 to July 2012 were taken as the research subjects and divided into the control group by the conventional inter-vention and the observation group(30 cases) by the psychological intervention and intraoperative cooperation according to the differ-ent intervention measures .The differences of delivery outcomes and the negative mood scores were compared between the two groups .Results The delivery outcome after receiving psychological intervention and intraoperative cooperation in the observation group was significantly better than that in the control group(P<0 .05);the negative mood scores after the systematic nursing in the observation group were significantly lower than those in the control group patients (P<0 .05) .Conclusion Using the whole course psychological intervention and intraoperative cooperation can effectively improve the maternal and fetal negative outcomes ,reduce anxiety ,depression and other negative moods .
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Objective:To evaluate the application of puncturing the umbilical cord under the ultrasound guidance in prenatal diagnosis,clinical high risk factors of fetal chromosomal abnormalities were discussed.Methods:283 pregnant women who had the percutaneous umbilical cord blood sampling were recruited and the karyotyping was done.The detection rate of chromosomal abnormalities and correlate factors in different subgroups of prenatal diagnosis were analyzed.Results:The success rate of puncture was 100%.Major complications were bleeing at the puncture site(33 cases,11.67%)and fetal heart brachycadia(5 cases,1.77%).25 chromosomal abnormalities were found and the detection rate was 8.83%.There was significant correlation between the couple's chromosomal abnormalities and the fetal's(r=22.348,P=0.000).Conclusions:The ultrasound guided percutaneous umbilical cord blood sampling proves to be valid in the prenatal diagnosis,especially when couples have chromosomal abnormalities.
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Objective To investigate apoptosis of placental syncytiotrophoblast in patients with early-onset and late-onset severe preeclampsia. Methods From November 2008 to May 2009, 15 cases with early-onset severe preeclampsia and 15 cases with late-onset severe preeclampsia matched with 10 women with normal pregnancies as control at Sixth Affiliated Hospital of Shanghai Jiaotong University were enrolled in this study. Enzyme-linked immunosorbent assay was used to measure syncytiotrophoblast microparticles (STBM) levels in peripheral venous plasma. Caspase-3 were measured by western blotting.Results (1)STBM: the level of STBM of (71 ± 21 )μg/L in early-onset group were significantly higher than (42 ±30)μg/L in late-onset group and (26 ± 11)μg/L in control group(P ＜0.05). The level of STBM in late-onset group and control group did not reach statistical difference ( P ＞ 0. 05 ). ( 2 ) Caspase-3:the level of caspase-3 protein were 0. 85 ± 0. 61 in early-onset group and 0. 77 ± 0. 46 in late-onset group,which were all significantly higher than 0. 32 ± 0. 15 in control group( P ＜ 0. 05 ). However, the level of caspase-3 protein in early-onset group did not show remarkable difference compared with that in late-onset group (P＞0. 05). Conclusion STBM are shed into the maternal circulation in higher amounts in earlyonset preeclampsia, which indicated that early-onset and late-onset severe preeclampsia may have different etiology and pathogenesis.
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Objective To investigate the incidence of vulvovaginal candidiasis(VVC)in the third trimester,and the effect on the of perinatal outcome.Methods Vaginal discharge samples of 300 gravida were examined and cultured for fungus.According to the clinical feature,the patients were divided into slight VVC group and heavy VVC group.The termination of pregnancy and perinatal outcome were recorded 42 days after delivery.Results The incidence of VVC was 34%.There was significantly higher prevalence of premature rupture of membrane(PROM),afterbirth adherence,premature labor,break of perinaeum when intrapartum,disruption of wound after intrapartum and infection of newborn in the group of heavy VVC,with significant difference as compared with non-VVC group (P＜0.01)but with no difference in puerperal infection(P＞0.05).Conclusion Heavy VVC is disadvantageousto the mothers and their babies in gravida,and the therapy of VVC in pregnant women should be conducted actively before and after delivery.
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Objective To investigate the incidence of pregnancy induced hypertention (PIH) in Shanghai during 1989～1998. Methods The data were analyzed retrospectively from three municipal general hospitals and five special hospitals obstetrics and gynecology. Results There were 158 790 deliveries in ten years. The total numbers of PIH were 8 852 cases. The incidence of PIH was 5.57%. The rate of mild, moderate and severe PIH was 55.83%, 29.39%, and 14.78% respectively. There were 114 cases (1.29%) complicated with eclampsia. The rate of cesarean section was 66.97% in PIH patients. The complications of PIH were as following: abruptio of Placenta 0.52%, heart failure 0.34%, renal failure 0.20%,DIC 0.07% hemolysis，elevated liver enzymes and low platelet count（HELLP） syndrome 0.03%, maternal death one case. There were 9 197 birth of 8 852 cases of PIH (twin 343 cases, triplets one cases).The perinatal death 66 occurred in cases (7.18‰) in which fetal death 48 cases, stillbirth 12 and neonatal death 6. Conclusion The incidence of PIH and the rate of perinatal infant death can be reduced by strengthen antenatal monitoring, prevention, early diagnosis and treatment of PIH.
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Objective To investigate the incidence of pregnancy induced hypertention (PIH) in Shanghai during 1989～1998 Methods The data were analyzed retrospectively from three municipal general hospitals and five special hospitals obstetrics and gynecology Results There were 158 790 deliveries in ten years The total numbers of PIH were 8 852 cases The incidence of PIH was 5 57% The rate of mild, moderate and severe PIH was 55 83%, 29 39%, and 14 78% respectively There were 114 cases (1 29%) complicated with eclampsia The rate of cesarean section was 66 97% in PIH patients The complications of PIH were as following: abruptio of Placenta 0 52%, heart failure 0 34%, renal failure 0 20%,DIC 0 07% hemolysis,elevated liver enzymes and low platelet count(HELLP) syndrome 0 03%, maternal death one case. There were 9 197 birth of 8 852 cases of PIH (twin 343 cases, triplets one cases) The perinatal death 66 occurred in cases (7 18‰) in which fetal death 48 cases, stillbirth 12 and neonatal death 6 Conclusion The incidence of PIH and the rate of perinatal infant death can be reduced by strengthen antenatal monitoring, prevention, early diagnosis and treatment of PIH