Objective To determine the safety of the fetal olfactory ensheathing cell(OEC) transplantation in patients with chronic spinal cord injury (SCI) by examination of the magnetic resonance imaging (MRI). Methods A prospective clinical study involving 16 patients with chronic SCI was designed to investigate the feasibility and biological safety of the fetal OEC transplantation in treatment of SCI. The olfactory bulbs from the 3-4-month-old aborted human fetuses following the strict ethical guidelines were harvested and trypsinized down to single fetal OEC. These cells were then cultured for 12-17 days and were prepared for a clinical use. From November 2001 to December 2002, 16 patients with chronic SCI were randomly enrolled. The patients suffered from SCI for1.5-8 years (average 4-3 years) after the injury. The suspension (50 μl) containing about 1×106 fetal OECs was transplanted by an injection into the patients’ spinal cords above and below the injury site. All the patients were assessed before thetransplantation and were followed up with MRI for 29-42 months (average 38 mon)after the transplantation. Results No cell-related adverse effects were observed in any patient during the followup period. The follow-up with MRI did not reveal any development of optic glial tumor, tumor-like mass, new hemorrhage,edema, expanding cyst, new cyst formation, infection or disruption of the neuralstructure in the transplant site of all the patients. Conclusion This is the first clinical study demonstrating the long-term safety of theOEC therapy for SCI. The results indicate that our protocol is feasible and safe in treatment of patients with chronic SCI within 38 months after the injury. Although the size of the samples for our study was not big enough, the positive results of the study have encouraged us to make a further research in this field.
摘要:目的: 探讨临床护理安全规范化管理的有效方法和效果。 方法 :成立病房护理安全管理小组;完善护理安全管理制度,培养质量管理意识;改善重点环节工作流程,强化质量监控;构建护理安全文化氛围。 结果 : 患者满意度明显提高,用药错误、管道脱落、压疮、投诉等发生率明显降低(〖WTBX〗P lt;0005)。 结论 : 规范化的护理安全管理提高了护理质量,保障了患者的安全,有效降低了护理风险的发生。Abstract: Objective: To discuss a effective way and effect of standardardized management of clinical nursing safety.Methods :Setted up nursing safety management team; Improved the nursing safety management system and trained awareness of quality management; Improved workflow of key links,and strengthened the quality control; Built a nursing safety culture. Results : Patients satisfaction improved obviously, and the medication errors、 pipe off、pressure sores、the incidence of complaints such as decreased obviously(P lt;0005).Conclusion : Standardized management of nursing safety improved the nursing quality, protected patients safety, and effectively reduced the risk of the occurrence of nursing.
Since 2015, when the day surgery mode was officially reckoned and supported by the National Health Commission, the day surgery model has entered the new period of rapid development. But at the same time, challenges in the vacancy of the evaluation indexes of the medical quality and safety of day surgery still pose obstacles to its growth. At present, there is no nationally unified evaluating index or appraising system for the day surgery-related medical quality and safety. In this paper, based on structure-process-outcome theory, the day surgery practice and involved researching literature were retrieved, reviewed, and analyzed. Also, the practice model at West China Hospital of Sichuan University (a pioneer day surgery hospital in China) was comprehensively compared with the National Clinical Improvement System. From the aspect of day surgery medical quality and safety evaluation indicators, it is hoped to provide an evidence-based method and evaluation of day surgery, and a theoretical basis for establishing policies and data reference.
Objective To assess efficacy of a mouthwash containing 0.1% cetylpiridinium on gingivitis and plaque and its safety. Methods Multi-center randomized double-blind trial with positive control and split-mouth comparison was designed. Scaling on teeth of left side were conducted at do then on those of right side at D8. The cases rinsed five times a day in same way with assigned agents. Efficacy was measured using before-after differences of clinical and microbial variables. Re-examinations were scheduled at D4 and D8. Brushing was refrained between D0 and D4, resumed between D4 and D8. Results There were 144 patients with gingivitis included, 4 lost follow up. Data of 69 cases in test group and 71 in control group could be analyzed. Baseline data analysis showed that distributions of sex, age and values of clinical and microbial variables in both groups were well comparable. At D4 plaque accumulations of the scaled side in both groups were in same level, and Gingival index (GI), sulcus bleeding index (SBI) and VAS for halitosis were significantly reduced. At D8 the measurements of plaque index (PI), GI, SBI and VAS of halitosis decreased significantly more than those of D4. More than half of the suspected pathogenic strains were eliminated and log value of its CFU/ml decreased significantly but at same level in both groups. The balance of intra-oral bacterial flora was not disturbed. Seventeen cases in test group (24.6%) had minor and transient adverse reactions related to the mouthwash. Antimicrobial tests in vitro confirmed that the test agent could kill or inhibit growth of the pathogenic bacteria involving with oropharyngeal infection, gingivitis, periodontal diseases and caries. Conclusion The mouthwash containing cetylpiridinium could inhibit plaque, reduce severity of gingivitis and halitosis, with acceptable minor adverse reactions, similar to those of the marketed cetylpiridinum solution.
ObjectiveTo evaluate the safety of TiRobot-guided percutaneous transpedicular screw implantation.MethodsThe medical records of 158 patients with thoracolumbar fractures and lumbar degenerative diseases who underwent percutaneous transpedicular screw implantation were retrospectively analyzed between January 2018 and December 2020. The patients were divided into trial group (TiRobot-guided screw implantation, 86 cases) and control group (fluoroscopy-guided screw implantation, 72 cases). There was no significant difference in gender, age, pathology, lesion segment, and the average number of screw implantation per case (P>0.05). The operation time, fluoroscopic dose, fluoroscopic time, and fluoroscopic frequency were compared between the two groups. One day postoperatively, the convergence angle was measured and the penetration of the pedicle cortex was evaluated according to Gertzbein-Robbins classification standard.ResultsThe operation time, fluoroscopic dose, fluoroscopic time, and fluoroscopic frequency of the trial group were significantly lesser than those of control group (P<0.05).One day postoperatively, the convergence angle of trial group was (21.10±4.08)°, which was significantly larger than control group (19.17±3.48)° (t=6.810, P=0.000). According to the Gertzbein-Robbins classification standard, 446 pedicle screws were implanted in trial group, trajectories were grade A in 377 screws, grade B in 46 screws, grade C in 23 screws, and the accuracy of screw implantation was 94.8%; 380 pedicle screws were implanted in control group, trajectories were grade A in 283 screws, grade B in 45 screws, grade C in 44 screws, grade D in 6 screws, grade E in 2 screws, and the accuracy of screw implantation was 86.3%. There was significant difference in the accuracy of screw implantation between the two groups (χ2=25.950, P=0.000). ConclusionCompared with traditional percutaneous transpedicular screw implantation, TiRobot-guided percutaneous transpedicular screw implantation can improve the accuracy of screw implantation, reduce radiation exposure, and improve surgical safety, which has a good application prospect.
Electric and electronic products are required to pass through the certification on electrical safety performance before entering into the market in order to reduce electrical shock and electrical fire so as to protect the safety of people and property. The leakage current is the most important factor in testing the electrical safety performance and the test theory is based on the perception current effect and threshold. The traditional method testing the current threshold for perception only depends on the sensing of the human body and is affected by psychological factors. Some authors filter the effect of subjective sensation by using physiological and psychological statistical algorithm in recent years and the reliability and consistency of the experiment data are improved. We established an experiment system of testing the human body's current threshold for perception based on EEG feature analysis, and obtained 967 groups of data. We used wavelet packet analysis to detect α wave from EEG, and used FFT to do spectral analysis on α wave before and after the current flew through the human body. The study has shown that about 97.72% α wave energy changes significantly when electrical stimulation occurs. It is well proved that when the EEG feature identification is applied to test the human body current threshold for perception, and meanwhile α wave energy change and human body sensing are used together to confirm if the current flowing through the human body reaches the perception threshold, the measurement of the human body current threshold for perception could be carried out objectively and accurately.
We searched The Cochrane Library（Issue 3, 2005）, MEDLINE（1996-2005） ,CMCC（1996-2005）, VIP（1996-2005） ,CNKI（1996-2005） to summarize the available evidence of topiramate for an intractable epilepsy. After scanning all these articles, we identified 11 articles including meta-analysis, randomised controlled trials and systematic reviews to evaluate. Topiramate offered an alternative in the treament for intractable epilepsy, especially for partial epilepsy, and its efficacy was proven. Patients had good tolerance. And no intercross effects with the traditional anti-epileptic drugs were found. So topiramate had broad clinical value. The primary dosage of topiramate was 200mg/d. The sustaining dosage was 400-600mg/d. And we didn＇t recommend the dosage of more than 600mg/d.
ObjectiveTo understand the current research status of conservative mastectomy with breast reconstruction for breast cancer, so as to provide a reference for surgeons and patients with breast cancer to choose surgical method. MethodThe recently domestic and foreign literature on the research of conservative mastectomy with breast reconstruction for breast cancer was reviewed and summarized. ResultsAt present, conservative mastectomy mainly included nipple sparing mastectomy, skin sparing mastectomy, and skin reduction mastectomy. All three surgical methods were safe and effective in the treatment of breast cancer, and the complications could be controlled. When combined with breast reconstruction, the better cosmetic effect could be obtained, and the postoperative satisfaction and quality of life of patients were markedly improved. ConclusionsAfter comprehensively preoperative evaluation for patients with breast cancer, conservative mastectomy provides a treatment choice for them. After conservative mastectomy, individualized reconstruction scheme is formulated according to size and sagging degree of breast, as well as individual expectations of patients, which can obtain a higher quality of life while treating diseases for patients with breast cancer.
Objective To investigate the effectiveness of HoloSight Orthopaedic Trauma Surgery Robot-assisted infra-acetabular screw placement for treatment of acetabular fractures. Methods The clinical data of 23 patients with acetabular fractures treated with open reduction and internal fixation and infra-acetabular screw placement in two medical centers between June 2022 and October 2023 were retrospectively analyzed. According to the the method of infra-acetabular screw placement, the patients were divided into navigation group (10 cases, using HoloSight Orthopaedic Trauma Surgery Robot-assisted screw placement) and freehand group (13 cases, using traditional X-ray fluoroscopy to guide screw placement). There was no significant difference in gender, age, body mass index, cause of injury, time from injury to operation, and Judet-Letournel classification between the two groups (P>0.05). The time of infra-acetabular screw placement, the fluoroscopy frequency, the guide pin adjustment times, the quality of screw placement, the quality of fracture reduction, and the function of hip joint were compared between the two groups. ResultsAll patients completed the operation successfully. The time of screw placement, the fluoroscopy frequency, and guide pin adjustment times in the navigation group were significantly less than those in the freehand group (P<0.05). The quality of screw placement in the navigation group was significantly better than that in the freehand group (P<0.05). Patients in both groups were followed up 6-11 months, with an average of 7.7 months. There were 9 and 9 cases in the navigation group and the freehand group who achieved excellent and good fracture reduction quality at 1 week after operation, and 12 and 12 cases with excellent and good hip joint function at last follow-up, respectively, and there was no significant difference between the two groups (P>0.05). The fractures in both groups healed well, and there was no significant difference in healing time (P>0.05). During the follow-up, there was no complication related to screw placement, such as failure of internal fixation, vascular and nerve injury, incisional hernia. ConclusionIn the treatment of acetabular fractures, compared with the traditional freehand screw placement, the HoloSight Orthopaedic Trauma Surgery Robot-assisted screw placement can reduce the time of screw placement, improve the accuracy of screw placement, and reduce the amount of radiation, which is an efficient, accurate, and safe surgical method.