失效模式与效应分析在消毒供应中心骨科外来器械清洗质量管理中的应用

目的探讨失效模式与效应分析(FMEA)在消毒供应中心骨科外来器械清洗质量管理中的应用效果。方法 2017年7～12月我院消毒供应中心应用FMEA理论对骨科外来器械清洗过程中可能存在的失效模式进行风险分析,计算优先风险数值(RPN),对高RPN值的失效模式分析其影响成因,同时优化重塑清洗流程,制定改进措施,观察比较FMEA管理前后各高风险失效模式的RPN值变化及器械清洗合格率。结果器械清洗不彻底、手工刷洗不到位、未按清洗流程操作、器械丢失或损坏是骨科外来器械清洗过程中的高风险失效模式。实施FMEA管理后,各高风险失效模式的RPN得分均低于管理前,管理后器械清洗合格率高于管理前,差异均有统计学意义(P <0. 05)。结论消毒供应中心在骨科外来器械清洗过程中应用FMEA进行管理,并采取相应措施干预,能提高骨科外来器械的清洗质量。

基于加速康复外科理念下综合护理评估对累及血管的副神经节瘤患者术后康复的影响

目的:探讨基于加速康复外科理念下运用综合护理评估对累及血管的副神经节瘤患者术后康复的影响。方法:回顾性分析2015年1月至2019年12月四川大学华西医院血管外科收治的累及血管的副神经节瘤患者40例,在加速康复外科理念和本中心实际情况下,根据围术期治疗方案不同,分为综合护理评估组(20例)和传统护理评估组(20例),比较两组患者手术时间、术中出血量、术中输血人数及术后并发症、术后住院天数的发生率。结果:传统护理评估组与综合护理评估组年龄、性别等基线资料差异无统计学意义(P>0.05)。传统护理评估组的手术时间为(270.40±35.39)min、术后住院天数为(10.80±2.78)d,综合护理评估组的手术时间为(192.80±42.35)min、术后住院天数为(7.80±1.93)d,差异有统计学意义(P<0.05)。结论:基于加速康复外科理念下对累及血管的副神经节瘤患者运用综合护理评估,科学地引导护士规范化的、合理使用护理评估工具,通过动态评估及护理干预措施,可有效完善术前准备,缩短术前等待时间,减少术中输血,缩短手术时间,降低术后并发症的发生率,从而减少术后住院时间,减少住院费用,加快患者的术后康复。

益生菌抗衰老作用机制研究进展

衰老会引起机体诸多不良的生理变化并增加对疾病的易感性,明确引发衰老的机制对于寻找其干预措施至关重要。研究发现,自由基氧化应激、炎症性衰老、免疫衰老、肠道菌群失调是引发衰老的相关机制。益生菌被报道具有潜在的延缓衰老作用,比较分析了常用益生菌抗衰老评价模型,并从衰老引发机制出发,重点综述了益生菌对肠道菌群的调节机制和抗衰老相关信号通路的影响,旨为进一步研究益生菌抗衰老作用提供新思路。

Phenolic extract of Morchella angusticeps peck inhibited the proliferation of HepG2 cells in vitro by inducing the signal transduction pathway of p38/MAPK

Morchella angusticeps Peck,one of the most popular edible mushrooms,has attracted great attention due to its delicious taste and healthy properties.However,both its biological effects and the possible mechanism of action have not yet been known.We investigated the anti-proliferative activity of the phenolic extract derived from Morchella angusticeps Peck(MPE)against HepG2 human hepatocellular carcinoma cells.Results showed that MPE at non-cytotoxicity doses significantly inhibited the proliferation of HepG2 cells in a dose-dependent manner with inhibitory rates ranging from 18 to 90%(P<0.01).The possible mechanism might be that MPE induced apoptosis through initiating the mitochondrial death pathway by regulating Bax,Bcl-2 and cleaved caspase-3.On the other hand,MPE might trigger cell cycle arrest at G0/G1/S phases by managing p21,Cyclin D1,cyclin-dependent kinases-4(CDK4)and proliferating cell nuclear antigen(PCNA).Additionally,MPE downregulated TRAF-2 and p-p53,while upregulated p-ASK1 and p-p38.Therefore,it could be inferred that MPE might induce the anti-proliferative function to HepG2 cells through the p38/MAPK signal transduction pathway.

基于本体的网络学习资源推荐算法设计

针对学习者在网络学习平台中面临的信息过载导致获取个性化信息不足问题,应用领域本体构建方法,对学习课件进行数据建模及表示,构建了一种基于领域本体与学习者属性信息的特征模型,模型结合领域本体主题及学习者基本信息要素具有语义支持并随时间推移进行更新.以学习特征模型为基础设计一种融合相似度的协同过滤推荐方法,有效缓解推荐算法面临的冷启动及其语义支持不足的问题.实验结果表明,所提的方法与传统的协同过滤推荐方法相比,数据推荐的准确率MAE减小12.29%,有效提高数据推荐质量.

Changes in phenolic content,composition,and antioxidant activity of blood oranges during cold and on-tree storage

Citrus fruits are rich in phenolic compounds that possess several health benefits.However,few studies have focused on the changes in phenolic compounds in citrus fruits during postharvest storage.This study dynamically monitored the phenolic content,components and antioxidant activity of‘Tarocco’blood oranges during a period of 12-week cold storage and on-tree storage,respectively.We investigated the alteration mechanism of phenolic compounds in blood oranges by evaluating phenylpropanoid pathway-related enzyme activities and gene expression.Results showed that flavanones were the main phenolic compounds in blood oranges.Both storage methods mainly stimulated the accumulation of phenolic acids to improve total phenolic content,which reached the maximum at week 12.Nonetheless,blood oranges had a higher phenolic content and antioxidant activity under on-tree storage than cold storage.Furthermore,the enzyme activities and gene expression of the phenylpropanoid pathway demonstrated that the accumulation of phenolics in blood oranges during storage was highly related to the activation of the phenylpropanoid pathway.These results demonstrate that on-tree storage is a potential approach for extending the supply period of blood orange from the perspective of phenolic compounds.

浅析工艺流程设计变等级

介绍了管道变等级的种类和统计材料的方法。

下肢慢性肢体威胁性缺血合并糖尿病的单中心治疗体会

目的总结我院近5年针对下肢慢性肢体威胁性缺血合并糖尿病治疗的单中心经验及治疗体会。方法回顾性分析2017年3月–2021年6月于我院诊断为下肢慢性肢体威胁性缺血合并糖尿病的病例,收集患者的基线信息、手术情况及随访结果。主要结局指标为术后1年目标动脉通畅率,次要结局指标为术后1年再干预率及术后1年截肢率。结果共纳入89名下肢慢性肢体威胁性缺血合并糖尿病的患者。85例(95.51%)接受经皮腔内血管成形术,其中7例手术失败,手术成功率91.76%(78/85)。3例接受人工血管股-腘动脉搭桥术,1例接受人工血管髂-股动脉搭桥,手术成功率100%(4/4)。78例行介入手术的患者中位随访时间为33个月。术后1年内2例病例死亡,术后1年生存率97.44%(76/78)。术后1年内再干预率为19.23%(15/78),1年目标血管通畅率(不包括死亡)为85.53%(65/76),1年截肢率为3.85%(3/78)。行旁路治疗患者中,随访时长13~48个月,随访期间未观察到人工血管血栓形成及再次闭塞,人工血管保持通畅。结论腔内血管成形术具有较为理想的术后血管通畅率,且手术创伤小,围术期风险低,在局麻下即可完成,可作为慢性肢体威胁性缺血患者的首选治疗方式;旁路手术远期通畅率好,但围术期风险较高,手术创伤较大,可作为介入治疗失败的备选方案。