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Objective To observe the changes of the blood culture results before and after implementing the quality control on blood culture .Methods The blood culture results in 1 year before implementing the quality control and in 1 year after implementing the quality control were performed the contrastive analysis .Results After implementing the quality control on blood culture ,the positive rate of blood culture was elevated by 2 .4% and the pollution rate was decreased by 8 .6% after the quality control .Conclu‐sion Implementing the total quality control on blood culture can improve the positive rate of blood culture and reduces the pollu‐tion rate of blood culture .The determination of contamination bacteria must combine the laboratory detection data with the clinical situation for ensuring to provide accurate and effective antimicrobial agents for clinic .

Objective To study the effect of simultaneously combined liver and kidney transplantation (SLKT) on end-stage liver and kidney diseases. Methods Thirteen cases subject to SLKT from 1996 to 2004 were reviewed in The First Affiliated Hospital of Sun Yat-sen University. Among them, there were 4 cases of polycystic liver and kidney, 4 cases of hepatic cirrhosis and renal failure, and 5 cases of fulminant heptic failure and hepatorenal syndrome. Ten were males and 3 females with an average age of 45.5 years old.Results Four cases of polycystic liver and kidney have all survived for more than one year after SLKT, and one of them has survived for 4 years. The 3 of 4 patients with hepatic cirrhosis and renal failure have survived more than one year, and one of them died perioperatively. The 2 of 5 patients with fulminant hepatic failure and hepatorenal syndrome have survived for one year, and 3 of them died perioperatively.Conclusion SLKT has been the effective therapy for end-stage liver and kindney diseases; The indications of SLKT for hepato-renal syndrome were discussed. SLKT may immunologically protect the renal graft.

Objectives To investigate the effects of orthotopic liver transplantation (OLT) plus non-biologic artificial liver support system (NBALSS) on fulminant liver failure(FLF), and efficiency of NBALSS on the preoperative preparation of OLT. Methods Seven FLF patients received OLT after 2 to 20 sessions of NBALSS therapy while waiting donor liver.Results Decreased serum bilirubin, improved hepatic encephalopathy and ascites was achieved in all 7 cases after NBALSS. Five of 7 patients have survived for 3 to 20 months after OLT, of whom 3 have had excellent quality of life for more than 18 months. Two patients died of hepatorenal syndrome or of hepatorenal syndrome and serious pancreatitis. Conclusions OLT plus NBALSS is one of the most effective therapies for FLF, NBALSS can be used to tide the FLF patients over until a donor liver is available.

Objective To study the molecular mechanism involved in early liver regeneration following cold ischemia after rat orthotopic liver transplantation(OLT). Methods Syngeneic(Lewis to Lewis)rat OLT with hepatic artery reconstruction was performed.Graft survival and liver regeneration following 1 h and 16 h cold ischemic injury were evaluated.Specimen were collected at predetermined intervals from 0,1,2,4,16,24,48,72 h post-reperfusion.The patterns of IL-6 and TNF-α expression,STAT3 activation,and upregulation of immediately early genes(IEGs)including c-fos,c-myc,and c-jun were determined in liver grafts with 1 h and 16 h cold ischemia times.Quantitative analysis of IL-6 at 2 h after reperfusion was performed for grafts preserved for 1 h and 16 h.Progression of hepatocyte replication was confirmed by bromodeoxyuridine(BrdU)immunohistochemistry.Positively BrdU-stained nuclei were quantitated and analyzed between the two groups at 48 h after reperfusion. Results Survival rate in the two groups was 100%.Compared to 1 h cold ischemia group,IL-6 and TNF-α expression and STAT3 activation in 16 h cold ischemia group were markedly increased.Extensive hepatocyte replication was present.Upregulation of immediate early genes of c-fos,c-myc,and c-jun was also observed.Grafts with 1 h ischemic iniury had lower levels of IL-6 than that when grafts suffering from ischemia for 16 h(t=27.7,P＜0.05).Number of positively stained nuclei in 16 h group were more than that in 1 h group at 48 h after transplantation(t=13.4,P＜0.05). Conclusions Severe cold ischemia initiated liver regeneration after rat OLT.TNF-α and IL-6 are important factors in early liver regeneration.IL-6/STA3 pathway in liver regeneration is an important part in the recovery of grafts following cold ischemia injury.

A sensitive method was developed for the determination of pacific ciguatoxin (P-CTX1) residue in fishes by high performance liquid chromatography coupled with electrospray tandem mass spectrometry ( HPLC-MS/MS). Homogenized samples of fish was extracted with acetone,degreased by freezing under -20℃ and filtered with filter paper. Then the supernatant was cleaned up with PSA column. Identification was achieved by electrospray ionization (ESI) in positive mode using multiple reaction monitoring. The calibration curve of P-CTX1 showed good linearity in the range of 0.5 -20μg/L with correlation coefficient of 0.9998. The limit of quantitation (LOQ) was 0. 1 mg/L( S/N = 10). The recoveries of P-CTX1 were between 82. 3% and 87. 2% (n =7) at spiked levels of 1.0 -20.0 ng/kg. The relative standard derivations( RSD) of the method were less than 7.8%.

Objective To study the value of MRI sequence and MRA in the diagnosis of reversible cerebral vasoconstriction syn-drome (RCVS).Methods MRI and MRA of 5 patients with RCVS were reviewed retrospectively.Abnormal distribution,morpholo-gy,signal intensity of the affected arteries and complication of RCVS on MRI and MRA were analyzed.Results All patients showed multifocal segmental vasoconstriction and dilatation of cerebral arteries on MRA,which sometimes was described as “string and beads”.There were 4 patients with cerebral parenchyma lesions,in which posterior reversible encephalopathy syndrome was showed in one case,cortical subarachnoid hemorrhage in one case,and watershed infarcts in 3 cases.Five patients recovered after 3 months. Conclusion MRI and MRA can clearly show cerebrovascular morphology and observe parenchymal secondary lesions,which have an important guiding significance for clinical treatment and prognosis assessment.

Objective To evaluate clinical significance of ischemia grade to predict severe arrhythmia in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 225 patients with STEMI admitting to emergency department were enrolled.All enrolled patients were divided into two groups based on the QRS complex electrocardiogram on admission:grade 1Ⅱ ischemia group(135 cases) and grade Ⅲ ischemia group (90 cases).All patients received thrombolytic therapy.The incidence rate of ST segment resolution (STR) and severe arrhythmia in hospital stay was observed.Results The ST segment elevation (Σ.ST) on admission and 2 h after thrombolysis in grade Ⅲ ischemia group was significantly higher than that in grade Ⅱ ischemia group [(0.84 ± 0.57) mV vs.(0.44 ± 0.35) mV,(0.50 ± 0.23) mV vs.(0.11 ± 0.06) mV] (P ＜ 0.01).The backing rate of ST segment ≥ 50％ 2 h after thrombolysis in grade Ⅲ ischemia group was significantly lower than that in grade Ⅱ ischemia group [56.7％ (51/90) vs.83.7％ (113/135)] (P ＜0.01).The creatine kinase MB (CK-MB) peak value in grade Ⅲ ischemia group was significantly higher than that in grade Ⅱ ischemia group [(363 ± 105) U/L vs.(212 ± 97) U/L] (P ＜ 0.01).There was no significant difference in the incidence of severe arrhythmia between two groups (P ＞ 0.05).Multiple Logistic regression analysis demonstrated that the independent predictors of severe arrhythmia were duration from symptom to thrombolysis and initial ΣST,whereas grade Ⅲ ischemia remained a strong predictor of severe arrhythmia.Conclusion Grade m ischemia on admission is associated with lower incidence of STR in patients with STEMI after thrombolysis and a strong predictor of severe arrhythmia.

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Radiation-induced skin injury refers to the acute and chronic skin damage caused when skin is exposed to radiation. Radiation-induced skin damage may be created by nuclear disaster, radiation accident, radiation therapy, occupational exposure and so on. Approximately 95% of patients receiving radiotherapy will eventually develop into radiation-induced dermatitis during or after the treatment. As a consequence, how to appropriately prevent and remedy radiation-induced skin injury is of great practical significance. According to traditional Chinese medicine, radiation-induced skin injury belongs to fire, heat and toxin, blocking Qi and blood, injuring the muscle surface, affecting the distribution of Qi, blood and body fluid in the body, and damaging the function of viscera. This paper summarizes the cognition and development of traditional Chinese medicine theory of radiation-induced skin injury, as well as the research progress of internal and external treatment of traditional Chinese medicine, so as to provide a basis for the research and treatment of radiation-induced skin injury with traditional Chinese medicine.