Mitochondrial quality control includes mechanisms such as mitochondria-derived vesicles, fusion / fission and autophagy. These processes rely on the collaboration of a variety of key proteins in the inner and outer membranes of mitochondria to jointly regulate the morphological structure and functional integrity of mitochondria, repair mitochondrial damage, and maintain the homeostasis of their internal environment. The imbalance of mitochondrial quality control is associated with leukemia. Therefore, by exploring the mechanisms related to mitochondrial quality control of various leukemia cells and their interactions with immune cells and immune microenvironment, this article sought possible targets in the treatment of leukemia, providing new ideas for the immunotherapy of leukemia.
The scientific research on prevention and control of coronavirus disease 2019 (COVID-19) has been a major and urgent task, of which clinical trials occupy a pivotal position in the entire prevention and control system. 204 relative clinical trials of traditional Chinese medicine (TCM) have been registered on Chinese Clinical Trial Registry. Through the analysis of all online public protocols of registered trials, it is found that the clinical studies of TCM in China showed lack of research foundation, tight time and heavy tasks, difficult clinical implementation, and disturbance by changes of the epidemic status. Based on these characteristics, this paper put forward several thoughts and suggestions on the quality management and design improvement for clinical trials of TCM preventing and treating COVID-19, in order to improve the quality of clinical trials in China, provide effective supports for the public health decision-making on the epidemic, and also give a reference for the prevention and control of epidemics in the future.
ObjectiveTo analyze the influencing factors for image quality of 18F-deoxyglucose (FDG) positron emission tomography (PET)/CT systemic tumor imaging and explore the method of control in order to improve the PET/CT image quality. MethodsRetrospective analysis of image data from March to June 2011 collected from 1 000 18F-FDG whole body tumor imaging patients was carried out. We separated standard films from non-standard films according to PET/CT image quality criteria. Related factors for non-standard films were analyzed to explore the entire process quality control. ResultsThere were 158 cases of standard films (15.80%), and 842 of non-standard films (84.20%). Artifact was a major factor for non-standard films (93.00%, 783/842) followed by patients’ injection information recording error (2.49%, 21/842), the instrument factor (1.90%, 16/842), incomplete scanning (0.95%, 8/842), muscle and soft tissue uptake (0.83%, 7/842), radionuclide contamination (0.59%, 5/842), and drug injection (0.24%, 2/842). The waste film rate was 5.80% (58/1 000), and the redoing rate was 2.20% (22/1 000). ConclusionComplex and diverse factors affect PET/CT image quality throughout the entire process, but most of them can be controlled if doctors, nurses and technicians coordinate and cooperate with each other. The rigorous routine quality control of equipment and maintenance, patients’ full preparation, appropriate position and scan field, proper parameter settings, and post-processing technology are important factors affecting the image quality.
ObjectiveTo analyze standards of alginate-based medical devices at home and abroad, and to emphasize key issues of quality control that should be concerned about.MethodsBased on investigation of alginate application in medical devices and alginate-related medical standards, alginate-related technical indicators and quality control points were comprehensively analyzed.ResultsWith the rapid development of alginate-based medical materials and medical devices, the relevant standards at home and abroad have been elaborated on the basic technical indicators and detection methods. In addition to Chinese Pharmacopoeia, China has issued one alginate standard for tissue engineering and three alginate related product standards.ConclusionConsidering the special physical and chemical properties of alginate, researchers also need to focus on the sterilization method, expiry date, molecular weight, and ratio of α-L-guluronic acid to β-D-mannuronic acid of alginate, and impurity content.
Quality control of cardiopulmonary bypass (CPB) in clinic is key to keep patients’ safety. In recent years, a quality control system for CPB is well developed in West China Hospital, including a monitoring part and a clinical management. After 5 years of its implementation, it has been shown that this system not only ensures patients’ safety but also enhances the quality of CPB, reducing the incidence of CPB-related complications and improving the prognosis. This article will introduce in details the implementation and standards of this clinical quality control system. We believe the system may help establish CPB quality control standards in China.
ObjectiveTo improve health care quality and safety by monitoring the performance of PhilipsPrecedence Dual-head single photon emission computed tomography (SPECT). MethodsWith our own homemade point source and the center of rotation model, in accordance with NEMA standards and manufacturers' design conditions, these three indicators including energy peak position of the instrument, intrinsic uniformity and center of rotation were routinely tested between 2008 and 2012 for the Philips-Precedence Dual-head SPECT in our hospital. In addition, the quality control was performed twice a week, and every year the total number of quality control was basically the same. We calculated the results by the weighted average method. ResultsThe 5-year average energy peaks of detector 1 and 2 were (139.23±0.32) and (138.97±0.45) keV, respectively, and they were both within the range of reference values [(140±3) keV]. In addition, the results of center of rotation were also in the normal range, and kept stable. Based on the analysis of quality-control data, for detector 1, compared with the data of 2008, there was no significant diTherence for central field of vision (CFOV) and useful field of vision (UFOV) in these three years from 2009 to 2011 (P>0.05). The diTherence was only significant between data of 2008 and that of 2012 (P<0.05). For detector 2, compared with the data of 2008, there was no significant diTherence for CFOV and UFOV in 2009 and 2011(P>0.05), while there was significant diTherent in 2010 and 2012 (P<0.05). ConclusionThe uniformity of SPECT will gradually deteriorate with prolonged use. However, regular quality control and maintaining can keep the function stabilization, and enhance the availability rate.
Objective To analyze and compare the domestic quality standard and foreign quality standard of sodium hyaluronate (HA), and to expatiate on the critical process monitoring parameters. Methods Different quality standards of HA were compared by translating and sorting, and some experimental data were analyzed as well as the manufacturing practice was elaborated. Results Differences exist in raw materials standard or specifications of products between domestic and foreign, but the basic control points are concordant. Conclusion The company should set up reasonable and controllable quality standard based on quality requirements and related process characteristics so as to assure the safety and effectiveness of the clinical application.
Objective To monitor surgical quality and analyze learning curve of minimally invasive totally thoracoscopic cardiac surgery. Methods We retrospectively analyzed the clinical data of 150 consecutive patients who underwent minimally invasive totally thoracoscopic cardiac surgery in the Guangdong General Hospital between January 2013 and December 2015. There were 60 males and 90 females at age of 43.1 years. There were 60 patients with atrial or ventricular septal defect repair, 12 patients with cardiac tumor resection, 53 patients with mitral valve replacement and 25 patients with mitral valve repair. According to the surgical sequence, all the patients were divided into 3 groups including a group A, group B, and group C with 50 patients in each group (every 10 patients as a sequence, every 5 sequence as a group). Surgical outcomes were compared among the 3 groups, and surgical quality was analyzed with descriptive statistics. Results Surgical failure rate was 6.7% (10/150). There was no in-hospital mortality. Aortic cross-clamp time, cardiopulmonary bypass time and duration of mechanical ventilation, duration of ICU stay, duration of hospital stays of the group C were significantly shorter than those of the group A and group B. Analysis showed a significant learning curve effect in totally thoracoscopic cardiac surgery. When surgical cases reached about 100 cases, cardiopulmonary bypass and aortic cross-clamp time was shorter than the average value stably. Conclusion Totally thoracoscopic cardiac surgery is safe and reliable. For the beginners, it needs about 100 patients of surgery to master the totally thoracoscopic cardiac surgery.
ObjectiveTo explore the application of clinical pathway in patients undergoing orthopedic day surgery.MethodsPatients who were scheduled for orthopedic treatment at Day Surgery Department of the Second Hospital of Shanxi Medical University from May to October 2020 were selected as the clinical pathway group, and all of them were managed by clinical pathway. Patients who were scheduled for orthopedic treatment at Day Surgery Department of the Second Hospital of Shanxi Medical University from May to October 2019 were selected as the routine group, and all of them were managed by conventional clinical methods. The general conditions of patients, physicians’ work efficiency, medical costs and medical quality were compared between the two groups.ResultsThe clinical pathway group included 246 patients, and the routine group included 391 patients. There was no significant difference in gender, age or disease distribution between the two groups (P>0.05). Compared with the routine group, the clinical pathway group had obvious advantages in terms of average time spent by a physician in issuing a medical order each time [(5.64±3.29) vs. (2.12±1.05) min], average number of revisions per physician’s order (1.40±0.24 vs. 0.38±0.19), rate of filing medical records within 3 days (90.28% vs. 97.97%), hospital costs [(7462.10±1035.01) vs. (6252.52±1189.05) yuan], drug costs [(652.21±88.53) vs. (437.17±108.20) yuan], length of stay [(1.23±1.04) vs. (1.02±0.18) d] and delayed discharge rate (7.93% vs. 2.03%), with statistically significant differences (P<0.05). There was no significant difference between the two groups in terms of unplanned reoperation rate, unplanned rehospitalization rate, or patient satisfaction (P>0.05).ConclusionCompared with routine clinical management, clinical pathway management can improve work efficiency, reduce medical cost and improve medical quality more effectively in the implementation of orthopedic day surgery, which has very positive effects and is worthy of promotion and application.