Quality control refers to the general term of operation technology which activities to meet the quality requirements. Quality control is not only the need of the development of the laboratory itself, but also the important requirement of the laboratory accreditation organization for the development of the laboratory. To carry out quality control, first of all, a complete quality control system should be established. According to the pathological experiment process, which can be divided into pre-analysis, in-analysis and post-analysis quality control. There are some similarities between special staining and hematoxylin-eosin staining, but the details are slightly different. There are many kinds of special dyeing items, and each dyeing step is complicated, so it is difficult to control the quality according to the quality control technology of conventional pathological staining. This article reviews the whole process quality control of special dyeing by summarizing the literature and work experience, so as to contribute to the subsequent improvement of the quality of special dyeing.
ObjectiveTo briefly describe the specific contents of the “four-dimensional integration” standardized training model for neurology residents and analyze the implementation effects.MethodsSince September 2019, the Standard Training Center for Residents in Department of Neurology, Xuanwu Hospital of Capital Medical University trained residents under “four-dimensional integration” standardized training model, including primary knowledge teaching, basic skill training, clinical thinking training, and student group learning. The effect of the “four-dimensional integration” model was measured by comparing the midterm assessment results after four months of training of the resident trainees in Grade 2019 under the “four-dimensional integration” training mode (n=37) with those of the resident trainees in Grade 2018 under regular training mode (n=32). The midterm assessment was conducted through standardized and objective clinical examinations, including three evaluations (theory, skills, and clinical drills), and the pass rate of tests was evaluated through Fisher’s exact probability method for comparison between training groups.ResultsThere was no significant difference in the pass rate of theoretical assessment (100.0% vs. 96.9%, P=0.464) or the pass rate of Mini-Clinical Evaluation Exercise (100.0% vs. 90.6%, P=0.095) between the two groups. The pass rate of skill assessment in Grade 2019 was significantly higher than that of the students in Grade 2018 (94.6% vs. 71.9%, P=0.018).ConclusionThe “four-dimensional integration” standardized training model for neurology residents and it effect are worthy of recognition, which can provide a reference for medical teaching, especially for the standardized training of resident physicians.
ObjectiveTo analyze the relationship between maximum standardized uptake value (SUVmax) of primary tumor detected by 18F-FDG positron emission tomography/computed tomography (PET/CT) and clinicopathologic factors in stageⅠnon-small cell lung cancer (NSCLC), and investigate the prognostic value of PET/CT on pathological feature. MethodsWe retrospectively analyzed clinical data of 182 patients with stageⅠNSCLC who underwent 18F-FDG PET/CT scan before lobectomy or segmentectomy in China-Japan Friendship Hospital from April 2013 to June 2014. There were 121 male and 61 female patients with their ages of 34-85 (68.1±9.8) years. Clinicopathologic factors including sex, age, smoking history, histology, TNM stage, T stage, tumor size, lymphatic vessel invasion, blood vessel invasion (BVI) and visceral pleural invasion were evaluated to identify the independent factors affecting SUVmax by univariate and multivariate regression analysis. The diagnostic efficiency and best cut-off point of SUVmax were calculated by the receiver operating characteristic curve. ResultsThe univariate analysis identified that sex (P=0.015), smoking history (P=0.001), histology (P < 0.001), TNM stage (P=0.004), T stage (P=0.001), tumor size (P < 0.001), BVI (P=0.001) were factors affecting SUVmax. Only histology (P=0.001), tumor size (P=0.006), BVI (P=0.009) were found to be significant independent factors according to multivariate regression analysis. The SUVmax of primary tumor was a predictor for BVI with the highest diagnostic accuracy at a cut-off value of 4.85, the sensitivity and specificity were 65.5% and 71.7%. ConclusionThe SUVmax is correlated with histology, tumor size and BVI in stageⅠNSCLC, higher in patients with non-adenocarcinoma, lager tumor and positive BVI. Furthermore, the probability of BVI could be predicted by SUVmax of the primary tumor.
Objective To explore the application of the Handbook for the Training Nurses in the standardized training for nurses in pediatric surgery. Methods Twenty-four training nurses trained under the instruction of the Handbook for the Training Nurses in Department of Pediatric Surgery from July 2014 to December 2015 were included as the observation group. Their training effects were compared historically with those of twenty-four training nurses who were trained without the help of the handbook from January 2013 to June 2014 (the control group). Results After the completion of the half-year training, theoretical score of training nurses in the observation group was better than that in the control group, and the difference was significant (87.16±4.18 vs. 83.71±5.46; t=2.492, P=0.016). Meanwhile, the specialist practical skill examination of training nurses in the observation group, such as femoral vein blood collection, replacement of drainage bag and indwelling needle infusion in children, and emergency practical skill examination such as cardiopulmonary resuscitation and the use of simple respirator were higher than those in the control group; and the working performance scores of training nurses in the observation group, such as the ability to adapt to the environment, patient satisfaction, nursing document writing, work efficiency and morning questions were better than those in the control group; the differences were significant (P< 0.05). Conclusion The Handbook for the Training Nurses can help the training nurses to adjust their working environment, master the practical skills and nursing knowledge in pediatric surgery.
The informatization construction in medical field not only brings convenience to clinical doctors, but also creates huge data for clinical research. Taking the application of information technology in thoracic surgery as an example, we decide to talk about the establishment and application of esophageal cancer database based on standardized and structured electronic medical records. The aim, through the construction of database, is to improve clinical doctors’ management ability of esophageal cancer, to provide reference of the information construction to medical colleagues, and to promote the application of information in medicine.
The Diabetic Foot and Peripheral Vascular Disease Study Group, Chinese Diabetes Society, released an expert advice Recommendations of Chinese Experts on the Standardized Diagnosis and Treatment of Diabetic Foot During Coronavirus Disease (COVID-19) Pandemic, and the International Diabetic Foot Care Group and D-Foot International released a document Fast-track Pathway for Diabetic Foot Ulceration During COVID-19 Crisis: A Document from International Diabetic Foot Care Group and D-Foot International during the 2020 outbreak, respectively. Both have the same goals, but the implementation focuses are different. The aim of this article is to give an interpretation of both expert advices in terms of the general principles, the epidemic prevention and control, the family, community and hospitalization management model of diabetic foot, the holistic principle of diabetic foot standardized management, and the telemedicine application in the late epidemic period.
ObjectiveTo explore the effect of non-pharmaceutical therapy in patient with hypertension in Chengdu. MethodsFrom October 2010 to October 2011, a total of 33 general practitioners from 14 community health-care centers in Chengdu were trained by 2009 "Hypertension Guideline" of China for grass-root; each practitioner was required to manage 25 hypertensive patients during one year, based on standardized project. We evaluated the effect of non-pharmaceutical therapy before and after project and the antihypertensive effects from different therapy. ResultsBy the end of 2011, a total of 632 hypertensive patients[aged from 36 to 79 with an average of 65.72±8.55; 263 males with the mean age of (66.41±9.10) years old, 369 females with the mean age of (65.22±8.10) years old], who were eligible for criteria with complete data had been managed for one year. The non-pharmaceutical management includes quitting smoke, limiting alcohol, limiting salt diet, reducing weight and increasing regular physical activity. At the beginning of this project, the acceptance rate of such management were 75.96%, 71.43%, 99.01%, 73.28%, and 85.00%, respectively. After one year of such non-pharmaceutical management, the proportion of patient, who suffered from smoking, alcohol drinking, excess salty diet, overweight and obesity, and lack of physical exercise, decreased from 8.54%, 5.54%, 16.00%, 55.06%, and 23.73% to 3.80%, 1.42%, 2.69%, 34.43%, and 11.39%, respectively with statistical difference (P<0.001). Overweight and obesity is the main risk factor related to lifestyle. During one year management, Systolic blood pressure decreased by 25.81, 23.71, and 27.78 mm Hg (1 mm Hg=0.133 kPa) in the patients with non-pharmaceutical therapy, pharmaceutical therapy, and both, respectively; diastolic blood pressure decreased by 10.23, 3.99, and 10.46 mm Hg, respectively, in the three groups with statistical difference (P<0.05). ConclusionThrough the hypertension management, strengthening the cognition of non-pharmaceutical therapy for general practitioner can reduce both high blood pressure risk and cardiovascular risk significantly and comprehensively.
ObjectiveTo develop a standardized dataset for adverse drug reactions (ADR) of Chinese herbal formula granules (CHFG) to regulate the collection content of ADR, promote the standardization and normalization of ADR data collection for CHFG, and facilitate the sharing, integration, and analysis of adverse reaction data. MethodsWe used a combination of literature research, Delphi survey and consensus meeting. ResultsA Delphi survey questionnaire was constructed based on the results of literature research, including 6 domains and 76 items. After the Delphi survey and consensus meeting, a final CHFG adverse reaction dataset was developed, including 6 domains and 75 items. The six domains were patient details, suspected drugs, other treatments/concomitant medications, detailed information on the suspected adverse reaction, possible influencing factors (causes of the suspected adverse reaction), and details of the person reporting the suspected adverse reaction. Compared with the data collected by the National Adverse Drug Reaction Monitoring Center, this dataset introduced a new domain called "Possible influencing factors", which included several items such as irrational use of CHFG, toxic varieties of Chinese herbal medicine, storage and usage conditions, physical characteristics, processing methods, and patient diet. It also contained the information on Chinese medicine syndromes and other herbs in the prescription, and modified multiple items based on the particularities of formula granules. ConclusionThe development and application of this standardized dataset of ADR for CHFG can facilitate data collection, integration, and analysis, furthermore improve doctors' awareness of prescribing safely and enhance patient medication safety.
Prosthetics and orthotics is an applied discipline which require students to have a good ability of clinical application. However, the present doctor-patient tension poses great difficulties in students’ clinical practice and study, and thus proposes higher requirements in the talent cultivation. Standardized patients (SP), as a newly established teaching mode, has been applied well in such areas as internal medicine, diagnostics and clinical care for about 20 years in this country. However, in prosthetics and orthotics, we hardly have any SP teaching experience in China. According to the experience of using SP in clinical medicine, this article discusses the necessity of SP in the teaching of prosthetics and orthotics, explains the advantages and disadvantages of SP teaching, and analyzes the feasibility of SP application in the teaching of prosthetics and orthotics under the present situation. Finally, this article concludes that using SP can improve students’ motivation, interest in learning and communication skills with patients. Therefore, it will become a research direction and development trend of prosthetics and orthotics.
The establishment of brain metabolic network is based on 18fluoro-deoxyglucose positron emission computed tomography (18F-FDG PET) analysis, which reflect the brain functional network connectivity in normal physiological state or disease state. It is now applied to basic and clinical brain functional network research. In this paper, we constructed a metabolic network for the cerebral cortex firstly according to 18F-FDG PET image data from patients with temporal lobe epilepsy (TLE).Then, a statistical analysis to the network properties of patients with left or right TLE and controls was performed. It is shown that the connectivity of the brain metabolic network is weakened in patients with TLE, the topology of the network is changed and the transmission efficiency of the network is reduced, which means the brain metabolic network connectivity is extensively impaired in patients with TLE. It is confirmed that the brain metabolic network analysis based on 18F-FDG PET can provide a new perspective for the diagnose and therapy of epilepsy by utilizing PET images.