ObjectiveTo evaluate whether the human patient simulator-based training would improve the leadership and management skills in critical care unit physicians.MethodsThe 40 physicians was completed 1/2 day of training on the human patient simulator. Each subject participated in four scenarios in the rescue team and two experts scored emergency care skills and teamwork leadership/interpersonal skills. A multiple choice question examination and training effectiveness questionnaire were completed before and after training.ResultsThe training effectiveness had more advantages than traditional teaching.Improvement was seen in participants' scores in leadership skills ( 34.8％ ),interpersonal ability ( 36.5％ ) and self-confidence ( 29.9％ ).ConclusionHuman patient simulator training may be useful for leadership,teamwork,and self-confidence skills in critical care unit physicians.

Objective To evaluate the clinical value of angiographic diagnosis and effectiveness of transcatheter therapy in hemorrhage after cholecystectomy. Methods The site and cause of hemorrhage after cholecystectomy were verified by selective DSA in 5 patients and then followed by treatment with target artery embolization. The cause of hemorrhage after cholecystectomy wasn't verified by selective DSA in 4 patients,surgical resection was then carried out. Results Nine cases had hemorrhage with various degrees after cholecystectomy. 55.56% of them were arterial hemorrhage identified by angiography,including 5 cases treated with target artery embolization effectively without any other important complication. The other cases were cured by abdominal exploring operation totally belonged to venous hemorrhage. Conclusion DSA and interventional therapy are of great value for arterial hemorrhage after cholecystectomy,especially the method of embolization is safe and efficient.(J Intervent Radiol,2007,16: 696-698)

Objective To evaluate the efficacy and safety of itraconazole injection in treatment of invasive fungal infection in the patients with multiple organ dysfunction syndrome.Methods Invasive fungal infection in 15 patients with multiple organ dysfunction syndrome was treated with 200 mg itraconazole injection,twice a day on the first two days,then once a day,for 8 to 14 days.During the treatment,the symptoms and signs,the results of chemical detection were recorded.Everyday fungus,sputum,stool smear or culture were performed.Results The recovery rate,effective rate,and fungal clearance in this trial with itraconazole injection were 80%(12/15),86.7%(13/15),and 86.7%(13/15) respectively.The side effect was not found.Conclusion Itraconazole injection is an effective and safe drug against invasive fungal infection in patients with multiple organ dysfunction syndrome.

Objective To assess the effectiveness of the quotient of serum sodium to urinary sodium divided by (serum potassium) 2 to urinary potassium (SUSPPUP) in screening for primary aldosteronism (PA).Methods Among 952 patients with hypertension who had renin activity,aldosterone measurements and concomitant serum and urinary biochemistry data,204 patients were diagnosed as cases of PA and 261 as cases of essential hypertension.Diagnosis of PA was made in accordance with established laboratory criteria including renin activity and aldosterone,plasma aldosterone concentration/plasma renin activity (ARR),and saline loading test.The SUSPPUP ratio with the ARR were compared in two groups.Results The area under the curve of SUSPPUP and ARR was 0.797 and 0.796 respectively according to receiver operating characteristic curve,optimal cutoff of SUSPPUP was 1.0,the sensitivity and specificity of SUSPPUP was 98.9％ and 81％ respectively.Conclusions The SUSPPUP ratio is an inexpensive and rapid tool to assess the extent of mineralocorticoid excess,therefore,SUSPPUP ratio can be applied to screen PA in hypertensive patients.

Objective To analysis of the thyroid hormone test results of Abbott Architect ci16200 automatic biochemical-im-mune analyzer (Abbott system) and Roche Cobas e601 automated immunoassay analyzer (Roche system) .Methods The thyroid hormone(including T4 ,FT4 ,T3 ,FT3 ,TSH ) levels of 93 cases of serum samples were respectively detected by Abbott system (CMIA) and Roche system (ECLIA) ,and the results were analyzed .Results The thyroid hormone test results of the two systems had a good correlation ,and the coefficients of T4 ,FT4 ,T3 ,FT3 ,and TSH were 0 .960 ,0 .962 ,0 .976 ,0 .900 ,and 0 .999(P<0 .01) . However ,there were significant difference of the detection results of the two systems(P<0 .05) .Conclusion The thyroid hormone test results of Abbott system and Roche system are not comparable .

A study of the quality assurance system building made at the training bases in Zhejiang since 2011 found the following.Five management systems on training quality have been established, covering basic clinical conditions, training management, faculty management and training, training assessment,and training incentives.PDCA is called into play for continuous improvement and perfection to develop a training quality management system of local features and continuous improvement.

Objective: To establish real-time qPCR method to analyze each HLA-C allele expression level of individual.Methods:Database including exon 2&3 sequences of HLA class Ⅰalleles was built ,HLA-C allelic specific primers were designed and the real-time quantitative PCR method for analyzing HLA-C allele expression level was built .The allelic specificity of these primers were confirmed in database and 835 normal peripheral blood samples of Han population .The mRNA level of each HLA-C allele from 20 pairs of liver tumor tissues and non-tumor tissues was analyzed by the qPCR method we built .Results:20 pairs of allelic specific primers were designed to distinguish the two HLA-C alleles of each individual with frequency over 0.96%in 835 cases of Han population.Among 55%of the liver cancer tissues ,the expression levels of the two HLA-C alleles from the same tumor tissue changes differently compared to that of the relevant non-tumor tissue.Conclusion:This study provides method for HLA-C allele expression level analysis of Han population and each HLA-C allele expression level is inconsistent of liver cancer tissue .

Objective To explore the correlation between polymorphism of angiotensin converting enzyme (ACE) gene and hypertensive disorder complicating pregnancy (HDP) in Chinese people.Methods The 21 case-control studies on the correlation between polymorphism of ACE gene (genotype DD,DI,Ⅱ) and HDP in Chinese people were analyzed by meta-analysis.The analysis was performed on Review Manager 4.2 software.According to the result of test for heterogeneity,the random effects model was used to calculate the pooled OR value and 95% CI.Results Twenty-one case-control studies were enrolled in this meta-analysis,a total of 1486 HDP cases and 1758 controls were included.The pooled OR values (95% CI) of DD,DI,Ⅱ genotypes of ACE gene polymorphism for HDP risk were 2.60 (1.84-3.67),0.98 (0.76-1.27) and 0.46 (0.32-0.65) respectively.Conclusions Genotype Ⅱ of ACE is a protective gene against HDP and genotype DD is a susceptibility gene for HDP.

BACKGROUND: Uncontrolled-rate freezing in -80 ℃ refrigerator is convenient, while controlled-rate freezing in -196 ℃ liquid nitrogen is reliable and long-term, the combination of the two can simplify the process and has been successfully used in clinics. OBJECTIVE: To explore the influences of different cryoprotectants by ladder-style freezing from -80 ℃ low temperature refrigerator to liquid nitrogen on the cryopreservation of hemopoietic stem cells. METHODS: The experiments were divided into four groups: 10% dimethyl sulfoxide (DMSO) group, 5% DMSO combined with 3% hydroxyethyl starch group, 5% DMSO combined with 0.25 mol/L trehalose group, 5% DMSO combined with 3% hydroxyethyl starch and 0.25 mol/L trehalose group. Peripheral hemopoietic stem cells were cryopreserved by ladder-style freezing from -80 ℃ low temperature refrigerator to liquid nitrogen. The ultrastructural changes were examined by transmission electron microscopy, the expressions of Annexin-V, PI and Caspase-3 were detected by flow cytometry. RESULTS AND CONCLUSION: There was no significant difference in survival rate, apoptotic rate and necrotic rates of the cryopreserved cells in the four groups (P > 0.05). The ultrastructural changes had no significant difference under the transmission electron microscopy. The viability was more than 90% in frozen-thawed mononuclear cell colonies, and the apoptosis was roughly 50% in the frozen-thawed CD45+ cell population, which contained many mature cells. Of hemopoietic stem cells, early stage cells have greater resistance to damage of cryopreservation than late stage cells. It is concluded that the addition of hydroxyethyl starch or trehalose into DMSO exhibits no synergistic protective effect on the cryopreservation of hemopoietic stem cells.

e extra-adrenal pheochromocytoma.