目的 观察藏医滋补方“巴桑母酥油丸”对放射线-化学复合损伤小鼠骨髓不同细胞群增殖能力的影响，探讨其促进放射线-化学复合损伤机体外周血象恢复的机制。 方法 采用造血祖细胞集落分析方法、流式细胞术，检测灌胃巴桑母酥油丸后放射线-化学复合损伤小鼠骨髓细胞中早期红系祖细胞（CFU-E）、晚期造血祖细胞（BFU-E）、粒-巨噬系祖细胞（CFU-GM）、巨核系祖细胞（CFU-Meg）集落产率、骨髓细胞增殖周期各时相细胞比例、造血干细胞抗原-1（Sca-1）免疫表型阳性细胞数变化情况。 结果 巴桑母酥油丸组骨髓细胞S+G2/M期细胞比例高于生理盐水组（P＜0.05）和自然恢复的空白组（P＜0.01）；CFU-E、BFU-E、CFU-GM集落产率高于生理盐水组和空白组（P＜0.05）；CFU-Meg集落产率、Sca-1+细胞数在各组间差异无统计学意义（P＞0.05）。 结论 巴桑母酥油丸对放射线-化学复合损伤小鼠骨髓细胞具有促进增殖的作用，这可能是其促进放射线-化学复合损伤机体外周血象恢复的途径，但对不同阶段、不同系别的造血细胞其促进作用不同。
Objective To summarize the characteristics of surgery-related near misses including events composition, cause of incident, specialty category, personnel allocation etc, and to provide experience of feedforward control for the nurses in operating room and a clinical basis of safety standards for the management of operating rooms. Method The 240 surgery-related near misses occurred between July 2014 and July 2016 were retrospectively analyzed, using frequencies and percentiles to describe the count data. Results The 240 surgery-related near misses were mainly associated with surgical stitches (91 cases, 37.9%), surgical dressings (52 cases, 21.7%) and surgical instruments (45 cases, 18.8%). The main features of the 91 cases of surgical stitching included loss of suture needles (40.7%, 37/91) and fracture events (37.4%, 34/91). Among the 52 cases of surgical dressings, the most commonly were gauze dressing events (43 cases, 82.7%), in which 19 were with unclear numbers of retained gauzes in the reoperation patient’s body, and 15 were postoperative counting anomalies. Among the 45 cases of surgical instruments, the fracture and defect were the most common (21 cases, 46.7%). Conclusion The operation nurses should focus on the prevention of suture needle loss, the surgical dressings loss and the fracture and defect of surgical instruments, etc, to reduce or avoid the surgery-related near misses.
Objective To systematically review the efficacy of chlorhexidine versus povidone iodine in the prevention of wound infections after surgeries by meta-analysis. Methods All randomized controlled trials comparing these two disinfectants were searched from databases of PubMed, The Cochrane Library (Issue 3, 2016), EMbase, WanFang Data, VIP and CNKI from inception to August 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results A total of 14 randomized controlled trials were included. The results of meta-analysis showed that the chlorhexidine group had significantly lower rates in any surgical site infection (RR=0.71, 95% CI 0.58 to 0.88,P=0.001) and superficial incisional infection (RR=0.66, 95% CI 0.48 to 0.91,P=0.01) when compared with povidone iodine group. However, there were no significant differences in deep incisional infection (RR=0.51, 95% CI 0.23 to 1.11,P=0.09) and organ-space infection (RR=0.97, 95% CI 0.53 to 1.76,P=0.92) between the two groups. Furthermore, subgroup analysis revealed differences in any surgical site infection and superficial incisional infection could only be found in surgeries possibly contaminated. Conclusion Chlorhexidine may be superior in decreasing the incidence of infection in probably contaminated surgery.
Objective To investigate the relevance among sarcopenia, peripheral inflammatory, and nutritional factors, as well as the impact of sarcopenia on the prognosis of gastric cancer. Methods A total of 174 patients with gastric cancer in Department of Gastrointestinal Surgery in West China Hospital of Sichuan University from July 2016 to December 2020 were retrospectively included. The skeletal muscle index (SMI) of the third lumbar vertebra level was calculated using CT images, and male patients with SMI<52.4 cm2/m2 and female patients with SMI<38.5 cm2/m2 were considered sarcopenia. The key clinicopathological features of patients were collected for prognostic analysis. ResultsAmong the 174 patients with gastric cancer, 73 patients (41.95%) were diagnosed with sarcopenia. Compared with those of non-sarcopenia, the patients who were diagnosed with sarcopenia showed a significantly elder age and lower body mass index (BMI). In addition, males demonstrated a significantly higher rate of sarcopenia. Further, patients with sarcopenia showed a significant increasing in the incidence of postoperative pulmonary infections and length of hospitalization than patients without sarcopenia. The two groups showed significant differences in type 2 diabetes, peripheral C-reaction protein (CRP), interleukin-6 (IL-6), albumin, prealbumin, and hemoglobin. Overall, the multivariate analysis and Kaplan-Meier survival curves indicated that sarcopenic patients had a significantly lower survival rate than the non-sarcopenia patients. Conclusion Sarcopenia is closely related to higher levels of inflammation, malnutrition, and poor prognosis in patients with gastric cancer. Therefore, we should diagnose sarcopenia patients as early as possible, and give nutritional support to the patients.