OBJECTIVE To study the clinical effect of preventing and treating sterile phlebitis(abacterial phlebitis,SP) by infrared irradiation after peripherally inserted central catheterization(PICC).METHODS Totally 122 inpatients from the Zhejiang Provincial People′s Hospital were divided into two groups randomly,the control group and the experimental group.The control group was only treated with usual care after PICC,while the experimental group with both infrared irradiation and usual care.The incidence rate of SP and its correlation factor were compared between the two groups.RESULTS None in the experimental group got SP.Nevertheless,the control group got a 21.9%incidence rate.The development of SP mostly own to impassable intubation or repeating intubation.CONCLUSIONS For those patients with impassable intubation or repeating intubation during PICC operation,infrared irradiation shows greatly helpful and can obviously prevent the SP and diminish patients′ fee.

Objective To explore current situation of hospital outpatient injection room infection and to discusse relevant countermeasures of infection control .Methods A retrospective analysis was conducted in 245 patients admitted and got infected in our hospital outpatient department injection room from October 2012‐to October 2013 .By analyzing its infection type ,treatment time ,age ,etc .,and in winter and items ,air ,medical staff hand in spring and summer and fall of hospital respectively we understand the hospital infection and the seasonal relationship ,the related factors of hospital infection ,and develop targeted and effective inter‐vention measures .Results The outpatient injection room infection were mainly occurred in respiratory system and digestive sys‐tem ,the occurrence rates were 54 .29% (133/245) ,25 .31% (62/245) ,respectively .The infection rate of treatment time> 7 d (2 .74% ) apparently higher than < 7 d (1 .09% ) (χ2 = 56 .246 ,P= 0 .000) .The infection rate of people whose age over 40 (1 .91% )apparently higher than age < 40 (1 .13% ) (χ2 = 12 .316 ,P= 0 .000) .The qualified rate of atmosphere in Winter and Spring (68 .46% ) was significantly lower than summer and autumn (89 .23% ) (P<0 .05) ,the qualified rates of surfaces and hands of medical staffs (84 .62% ,82 .31% ) were significantly higher than summer and autumn(63 .08% ,66 .15% ) .Conclusion The out‐patient injection room infections were related to a variety of factors ,we could carry on the comprehensive analysis and formulate specific interventions to reduce hospital infection .

An electrogenerated chemiluminescence ( ECL) sensor was fabricated by employing ruthenium complex polymer as ECL signal and ionic liquid as binding reagent and a sensitive ECL method for the determination of heroin was developed. The ECL sensor was prepared by thoroughly mixing ruthenium complex polymer,graphite powder and ionic liquid,which shows good electrochemical and ECL behaviors. The detection limit for tripropylamine (TPA) was one order of magnitude lower than that observed at the paraffin modified carbon paste electrode. ECL intensity of the fabricated sensor was greatly enhanced in the presence of heroin and a sensitive ECL method was proposed for the determination of heroin based on the enhancement ECL. The ECL intensity was linear with the concentration of heroin in the range from 2. 0 ×10~(-9) mol/L to 2. 0×10~(-5) mol/L and the detection limit was 8×10~(-10) mol/L. The ECL sensor exhibited a long-term stability,fine reproducibility with relative standard deviation less than 5% for 5. 0×10~(-9) mol/L heroin in 60 continuous determinations. The developed method allows the detection of heroin in a serum sample with recovery in 94% -101%.

Objective To evaluate the effect of different tube voltages on the radiation dose and image quality of a full field digital mammography system.Methods Both experiments were performed under manual exposure mode.In one experiment,the tube voltages were kept constant at 25,28 and 31 kVp,and the CIRS 015 phantom was exposed at three target/filter combinations molybdenum/molybdenum (Mo/Mo),molybdenum/rhodium (Mo/Rh),and rhodium/rhodium (Rh/Rh) and at tube current-exposure time products of 32-140mAs.The entrance skin exposure (ESE) and average glandular dose (AGD) were recorded,the signal-to-noise ratio(SNR) and contrast-to-noise ratio (CNR) and figure of merit (FOM) were measured to evaluate the influences of different tube voltages on dose and image quality at same target/filter combination.The univariate of randomized completed block-design was used for statistics.In second experiment,the phantom were exposed using Mo/Rh combination when the tube current-exposure time product was kept constant at 56 mAs,and the tube voltage varied between 23 and 33 kVp in 1-kVp increments.The ESE and AGD were recorded,the SNR,CNR and FOM were measured for plotting the curves against tube voltages.Results At Mo/Mo combination,the AGD,ESE,SNR,CNR and FOM of 25,28 and31 kVp were(1.25 ±0.56) mGy,(6.46±2.86) mGy,71.52±8.37,1.91 ±0.26,3.21 ± 0.68; (1.94 ±0.85) mGy,(9.18±4.07) mGy,144.46 ± 11.31,2.41 ±0.28,3.37 ±0.96 and (3.01 ±1.38) mGy,(12.60±5.59) mGy,128.89 ±15.29,2.47 ±0.31,2.31 ±0.76 respectively; at Mo/Rh combination were (1.23 ±0.55) mGy,(5.26 ±2.33) mGy,67.31 ±4.11,1.82 ±0.19,3.01 ± 0.82; (1.86 ±0.84) mGy,(7.57 ±3.34) mGy,139.54 ± 12.16,2.30 ±0.25,3.23 ±0.92 and (2.81 ±1.24) mGy,(10.48 ±4.62) mGy,127.77 ±15.14,2.59 ±0.31,2.67 ±0.68; and at Rh/Rh were(1.09 ±0.48) mGy,(4.89 ±2.16) mGy,67.46 ±2.23,1.48 ±0.72,3.08 ± 1.69; (1.75 ± 0.78) mGy,(6.88 ±3.03) mGy,137.74 ± 14.65,2.37 ±0.26,3.62 ± 1.07 and (2.59 ± 1.13) mGy,(9.32 ± 4.12) mGy,117.91 ± 19.05,2.51 ± 0.31,2.74 ± 0.84.Both experiments indicated that,for a given target/filter combination,the AGD,ESE and CNR increased,but the ESE/AGD decreased with the tube voltage increasing; The first experiment indicated both SNR and FOM of 28 kVp were higher than that of 25 kVp and 31 kVp; the second experiment showed both SNR and FOM decreased with tube voltages increasing.The differences of AGD、ESE、ESE/AGD、SNR、CNR and FOM among the three tube voltages were significant (F =4.391-528.848,P ＜ 0.05) ; but the difference of CNR between 28 and 31 kVp at Mo/Mo and Rh/Rh had no statistical significance (P ＞ 0.05) ; and the differences of FOM between 25 and 28 kVp at the three target/filter combinations were not statistically significant (P ＞ 0.05).Conclusion For a breast with 4.2 cm thickness and 50％ adipose 50％ glandular composition,different tube voltages have significant effects on the radiation dose and image quality.

Objective:To study the applied value of CREG Zygosity Principles in kidney transplantation.Methods:Relationship between HLA CREG zygosity and acute rejection incidence was analyzed in 173 kidney transplantation and the concerned principles were discussed.Results:HLA-A,B,DR antigens of 0 mismatch (MM) were 7.51%,4.04%,3.46%;and those of 2 MM were 39.88%,65.31%,58.38% respectively.Compared in CREGs,A,B,and DR,the 0 MMs were 49.71%,30.63% and 24.27%;whereas 2MMs were only 5.20%,12.14% and 8.67%.In HLA-A,B and DR antigens 0 MM,the incidence of acute rejection was 21.96%,21.38% and 7.51% respectively;and in 2MMs,those were 22.54%,20.23%,and 66.67% respectively.Compared by CREGs A,B and DR 0 MM,acute rejection reached 21.83%,20.21% and 6.14%;and in 2MMs the incidence of acute rejection were 22.22%,20.00% and 69.82%.Conclusion:CREGs model is a novel method of choosing kidney transplantation donor-recipients’s matching.

A patient with impaired kidney function after kidney transplantation and received treatment at the First Hospital of Jilin University was retrospective analyzed. The patient was male, 45 years old, and was diagnosed hemolytic uremic syndrome by transplanted kidney biopsy. The patient received cyclosporine A (CsA) as maintenance centered immunosuppression therapy postoperatively. He was admitted because of 1 week acratia followed by 1 day increased serum creatinine level at 1.5 years after transplantation. At 1 day after admission, he was received renal needle biopsy, and underwent 2 days Prednlsolone treatment. After hemolytic-uremic syndrome was diagnosed, CsA was transferred to Tacrolimus (Fk506) with dose of 2 mg/d, and Azathioprine was replaced by mycophenolate, Prednisone was taken orally for 20 mg/d. The function of the transplanted kidney and the change of routine blood tests were observed. After 1 week treatment of the changed Immunosuppression therapy, the function of the transplanted kidney was improved obviously, and the hemoglobin and platelets was decreased during the treatment. The results demonstrated that kidney biopsy is a key method to diagnose hemolytic-uremic syndrome, and adjustment of immunosuppressive agents, replacing CsA with FK506 are effective for postoperative hemolytic-uremic syndrome.

Purpose To investigate the diagnostic utility of the immunohistochemical markers SALL4, D2-40 and Glypican-3 in prima-ry testicular germ cell tumors (TGCTs). Methods The expression of SALL4, D2-40 and Glypican-3 protein was detected by EnVi-sion immunohistochemical method in 56 cases of primary testicular germ cell tumors, including 5 intratubular germ cell neoplasms ( IT-GCNs) , 10 seminomas, 14 embryonal carcinomas ( ECs) , 14 yolk sac tumors ( YSTs) , 1 choriocarcinoma, 5 immature teratomas and 12 mature teratomas. 10 normal testicular tissues and 5 lymphomas were selected as control. Results All of ITGCNs, seminomas, YSTs and ECs were diffusely strongly positive for SALL4. Focal SALL4 staining was seen in choriocarcinoma, 3 of 5 immature terato-mas and 3 of 12 mature teratomas. All of ITGCNs, seminomas showed diffusely strong D2-40 staining. ECs (4/14) were focally posi-tive for D2-40, while choriocarcinoma, YSTs and teratomas were negative for D2-40. Glypican-3 was diffusely positive in YSTs (13/14), and focally weakly positive in ECs (2/14), respectively. ITGCNs, seminomas, choriocarcinoma and teratoma were negative for Glypican-3. In contrast, 10 normal testicular tissues and 5 lymphomas showed no SALL4, D2-40 and Glypican-3 staining. Conclu-sions SALL4 is a useful diagnostic marker with high sensitivity and specificity for TGCTs. Combination of SALL4, D2-40 and Glypi-can-3 is helpful to the diagnosis and differential diagnosis for TGCTs.

Objective To observe the transdifferentiation of renal tubular epithelial phenotype in allograft biopsy samples of patients with various rejections,and to analyze the association between rejection and transdifferentiation.Method Immunohistochemistry (SP method) was applied to detect α-SMA expression in tubular epithelial cells from 55 renal allograft biopsy samples with various rejection.Results Positive α-SMA expression was found in all the atrophic tubular epithelial cells adjacent to cytoplasm of basement membrane,which indicated the atrophic renal tubular epithelial cells appeared the phenotypic transdifferentiation.Positive α-SMA was also detected in some renal epithelial cells without atrophy.No phenotypic change was found in 7 cases without obviously rejection.Among 28 cases of acute T-cell-mediated rejection IA grade,α-SMA positive expression rate of non-atrophy renal epithelial cells was 25％-50％ in 1 case and 10％-25％ in 3 cases.Among 14 cases of more severe acute rejection group IB grade,α-SMA positive expression rate was over 50％ in 1 case,25％-50％ in 2 cases and 10％-25％ in 2 cases.Conclusion When acute T-cell-mediated rejection becomes more serious in renal allograft,the phenotype transdifferentiation aggravates in renal tubular epithelial cells.

OBJECTIVETo investigated the chemical structures and bioactivity of polysaccharides from Isatidis Radix.

METHODPolysaccharides were extracted and purified by column chromatograph and their chemical structures were identified by UV, IR, NMR, periodic acid oxadation and Smith degradation method and their stimulation effects to macrophage were evaluated by using MTT method.

RESULTFive polysaccharides, polysaccharide A , B, C, D and E were gotten and their molecular weights were 2 000, 1 757.1, 1 34 2.7, 955.6, 11.7 kDa, respectively. Polysaccharide A was composed of arabinose, polysaccharide E was composed of arabinose and galactose, polysaccharides B, C, D were composed of glucose and 1 --> 2, 1 --> 3, 1 --> 4, 1 --> 6 linkages existed in polysaccharides A-E, of A, B, C, D, E were alpha-configurations. Polysaccharides B, C and D showed better bioactivity than polysaccharides A and E with stimulation index (SI) of 5.31, 4.76, 5.17.

CONCLUSIONFive polysaccharides are seperated firstly from Isatidis Radix.

Objective:To investigate the clinical effect of spousal kidney transplantation , and to explore the significance in today's society.Methods:We retrospectively collected the relevant clinical data from the transplantation department of the first hospital of jilin university, from October 2009 to December 2018. Receptors who accepted spousal, parental and compatriot donor kidney is respectively obtained.Then the postoperative efficacy of the three groups were compared.Results:The graft survival rates of spousal kidney transplantation were 94.1% at 3 years and 83.7% at 5 years, which were not significantly different from other types of living kidney transplantation ( P=0.260). There was no significant difference in creatinine at each time point within 3 years after operation between three groups. At 3 years and 5 years after operation, there was no significant difference in creatinine between spouse group and sibling group.But the creatinine of spouse group was lower compared with parent group ( P=0.014, 0.038). The incidence of rejection within 1 years after spousal renal transplantation was 25%, which was significantly higher than parent group and sibling group ( P=0.029). Age of donor, gender of recipient, D/R BMI and incidence of AR or not in recipient were independent predictors for 1-year creatinine in living kidney transplantation (correlation coefficient: 0.048、-26.03、-15.95、10.23; P=0.003、<0.001、0.021、0.013). Conclusions:Spousal kidney transplantation has same clinical efficacy compared with other types of living kidney transplantation, which can greatly improve the donor kidney resource.So it worth being further promotion, but compared with other types of living kidney transplantation, we should be more alert to the incidence of rejection reaction, so as to obtain better curative effect.