Described in this paper are the JCI accredited domestic hospitals, what should be learned from the JCI accreditation standards by domestic hospital accreditation standards, enlightenments of JCI accreditation standards on improving domestic library service such as establishment of library management systems, provision of network reference service, predictive information service, first-asked responsibility system reference service, library mobile service, and prolongation of library open time.

Objective To evaluate the efficiency and safety of Percusurge guardwire distal protection system in coronary intervention in patients with acute myocardial infarction. Methods Three male patients with acute myocardial infarction were enrolled in the study. Primary angioplasty was performed for 2 of them, 2 and 7 hours after onset of the infarction symptom, respectively. Selective angioplasty was performed 17 days after infarction for the third case. Percusurge guardwire system was used during the procedure. Results Procedure success was achieved for all of the 3 cases. Lot of thrombus was sucked out. The infarct-related arteries had TIMI 3 flow at the end of the procedures. The patients′ symptoms were resolved soon after the procedure. Minor dissection was seen in one case which did not obstruct the distal flow and was left alone. Conclusion Percusurge guardwire system can be used safely and effectively in coronary intervention in the thrombus-laden arteries such as acute myocardial infarction.

Objective To summarize the effect and safety of percutaneous coronary intervention (PCI) for CHD in patients with single patent coronary artery. Methods We collected the data of CHD in 10 patients with single patent coronary artery who underwent PCI and analyzed them retrospectively. Results All patients with single patent coronary artery had successful PCI. Symptoms of all the CHD patients had been significantly relieved after PCI. No major adverse cadiac events occurred in hospitalization. Conclusion The data suggest that the patients with single patent coronary artery might be treated with PCI effectively and safely.

Objective To compare between conventional and endoscope-assisted greater saphenous vein harvesting and to invest if endoscope-assisted greater saphenous vein harvesting can reduce post-operative leg incision complications.Methods Minimally invasive endoscopic saphenous vein harsvesting technique has been used in 36 isolated CABG patients and this is compaired with 50 conventional saphenous vein harsvesting group. There is no significant difference in sex structure, age, hypertension, diabetes mellitum (DM), myocardial infarction (MI) et al in two groups. Results The incidence of post-operative leg complications with minimally invasive greater saphenous vein harvesting group (2.8% ) was remarkably lower than that in conventional group (28%), and the hospital-stay time was much shorter in minimally invasive group. Conclusion Endoscope-assisted saphenous vein harvesting is a effective method in reducing post-operative leg incision complications.

Objective To explore the effect of bone marrow stromal cells (BMSC) transferred by Nell-1 gene combined with biomaterial fibrin glue (FG) to enhance segmental bone defect healing in dog mandible. Methods Nell-1 gene vector was reconstructed in retroviral vector and then transfected BMSC. The protein of Nell-1 gene in transferred cells was determined by immunohistochemistry. Segmental defects were created surgically in the dog’s mandible. The defect was repaired with BMSC transfected by Nell-1 retroviral granules in presence of FG,untransfected BMSC in combination with FG,and FG alone. The control group was left untreated. The defect-repairing capability for each treatment were assessed by gross observation,radiography,and histology at 8th week and 16th week. Results Cells transfected by Nell-1 retroviral granules expressed abundant Nell-1 mRNA and protein in the cytoplasm. Positive results were not found in those cells that were not transferred. The use of BMSC transferred by Nell-1 retroviral granules combined with FG materials exhibited the strongest defect-repairing ability. Gross observation,radiographical and histomorphometric analyses revealed a significantly greater total area of bone formation,increased amount of the new bone in the defects than in those treated with the untransfected BMSC. Conclusion Nell-1 gene transfection may be used to promote the osteogenic ability of BMSC.

Objective To study the validity of continuous positive airway pressure(CPAP)curing overlap syndrome.Methods Comparisons were made in the respiratory disturbance index(RDI)the longest apnea time the longest hypopnea time etc between before and after-treatment.Results The respiratory disturbance index(RDI)、the longest apnea time、the longest hypopnea time were signifi- candy different(P＜0.05).Conclusion Continuous positive airway pressure is an effective method to treat overlap syndrome.

ObjectiveTo explore the long-term fluctuation of fasting plasma glucose (FPG) and its effect on prognosis in patients surviving for more than 1 year after renal transplantation.MethodsFour hundred and forty-six patients underwent kidney transplantation from January,1993 to December,2008.According to preoperative FPG levels,patients were divided into diabetic,impaired fasting glucose (IFG),and normal fasting glucose (NFG)groups. The changing trend of FPG level was observed and analyzed. For 428 non-diabetic patients before transplantation,the prevalence and different outcomes of post-transplantation diabetes( PTDM ) according to FPG after transplantation were analyzed.The characteristics of the patients with persistent PTDM ( P-PTDM ) and transient PTDM (T-PTDM) were compared.The incidence of complications and patient survival between the PTDM group and non-PTDM groups were also compared.ResultsFPG level was increased early and then decreased in patients after renal transplantation.Of the 428 patients,87 developed into PTDM ( 20.3％ ) including 15 T-PTDM patients ( 17.2％ of total PTDM ),who eventually recovered to NFG or IFG.Compared with P-PTDM group,the incidence of acute rejection episodes was higher for T-PTDM ( P =0.043 ).The incidence of infections,hypertension,and dyslipidemia within the first year,was higher in PTDM group compared with non-PTDM group but patient survival was not different within a mean follow-up of ( 5.65 ± 3.68 ) years.ConclusionPTDM will not be permanent and may recover to NFG or IFG in the course of the disease.Acute rejections are associated with the onset of T-PTDM.The overall patient survival is not affected by PTDM,although complications,such as infections,hypertention,and hyperlipidemia are more frequently encountered in PTDM patients.

Objective:To explore the diagnosis and treatment of ketamine-associated urinary system dysfunction. Methods:Total-ly 56 cases of urinary tract symptoms with the history of ketamine abuse in recent years were retrospectively analyzed. The routine ex-amination and the examination related to the urinary system were given, and individual treatment was undertaken according to different situation. Results: The main symptom of ketamine-asscociated urinary tract dysfunction was lower urinary tract symptom (LUTS). Bladder pathologic biopsy showed different degree of inflammatory change. Imaging examination showed various degree of pathological changes, including reduced bladder capacity, thickened bladder wall, bladder contracture, ureteral stricture and hydronephrosis. Three patients had increased serum creatinine level. Conclusion: Ketamine-asscociated urinary system dysfunction is a disease with LUTS as the main clinical symptom. At the early stage, the disease is reversible with promising treatment outcome. In the progression of the disease, some patients develop irreversible histological changes in the urinary tract, which should be brought to the forefront.

Objective To investigate the association of serum angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) with myocardial reperfusion in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). Methods A total of 103 consecutive STEMI patients who received primary PCI were enrolled in this study. The patients were divided into two groups according to ST-segment resolution (STR) at 2 h after PCI:STR ≥ 50%group (n=69) and STR<50%group (n=34). Serum concentrations of Ang-1, Ang-2 and Ang-2 to Ang-1 ratios (Ang-2/Ang-1) before and immediately after PCI, 2 h, 6 h, 24 h after PCI were compared. Predictors of poor STR were identiifed by multivariable logistic regression analysis. Results The patients with STR≥50%had significant higher serum Ang-1 levels (P < 0.05) and lower Ang-2/Ang-1 ratios (P < 0.01) from before PCI to 6 h after PCI than those with STR < 50%;Ang-1 and Ang-2/Ang-1 at 24 h after PCI, and Ang-2 at all time points were not signiifcantly different between the two groups (P>0.05). In multivariable logistic regression analysis, Ang-2/Ang-1 before PCI was independently associated with STR < 50%;Other independent predictors were pain to balloon time, infarct related artery (LAD), and TIMI flow grade<Ⅲafter PCI. Conclusions Higher Ang-2/Ang-1 is an independent predictor of poor myocardial reperfusion in STEMI patients after PCI.

Objective To study preliminary the accuracy of clinical target volume (CTV) and internal target volume (ITV) automatically generated by an in-house deformable registration software on fourdimensional CT (4DCT),and evaluate its feasibility of clinical application.Methods Clinic treated one lung cancer patient and one liver cancer patient were selected for the study.CTV was delineated by radiation oncologist according to a single respiratory phase image of 4DCT scanning,and then deformed to the other phases and generated the CTVdefm on each phase image.Differences between the CTVdefm and CTVmanu were then compared.A composite ITVcopm was created by overlapping all the CTVdefm of 10 phases and compared with the ITVMIP which was contoured on the maximum intensity projection (MIP) CT images,including the shape,volume and geometric center position of the ITV contour.Results For the tested lung case,average volume difference between the CTVdefm and CTV was (-2.59 ± 5.02)％ for the all 10 phases,and the vector departure of the two ITV centers was (1.04 ± 0.89) mm.The ITVcomp almost completely matched the ITVMIP on the tested liver case with a volume difference smaller the 1％ and only 1.4 mm vector departure between their geometric centers.Conclusion The validity of the CTVdefm and ITVcomp gained from automatic deformation of manual delineation reference based on 4DCT images were preliminary evaluated and proved to be good enough for clinic planning.