BACKGROUND: Biliary ischemia-reperfusion injury is one of the main reasons for the injury bile duct following liver transplantation, liver resection and hepatic artery thrombosis after chemotherapy. However, nothing has been decided yet concerning liver can tolerate long intrahepatic bile ducts ischemia under normal temperature. OBJECTIVE: To use the rabbit biliary ischemia-reperfusion injury, model, analyze the rabbit intrahepatic bile ducts ischemia security time. METHODS: Rabbits were randomly divided into sham operation, hepatic artery and common bile duct joint blocking 1.5, 2, 2.5, 3 h groups. Sham operation group only free common bile duct, hepatic artery and portal vein. Hepatic artery and common bile duct joint blocking 1.5, 2, 2.5, 3 h groups, left and right hepatic duct openings superior margin was clamped using artery clamps, and hepatic artery, common bile duct and loose connective tissue were occluded. Following 1.5, 2, 2.5 and 3 hours, artery clamps were removed to recover hepatic artery or biliary tract blood flow. After a week, animal survival was calculated and liver function was tested. RESULTS AND CONCLUSION: None animals in the sham operation and hepatic artery and common bile duct joint blocking 1.5 hour groups died;survival rate was 87.5% following 2 hours of blocking. Animal survival rate was decreased gradually with prolonged blocking time of blood flow. These indicated that the maximum safety time of blocking biliary duct blood flow was 2 hours. Pathological and histological changes were mild within 2 hours of blocking, mainly presenting cell edema and inflammatory cell infiltration, and necrotic focus was punctiform or fragmentis, reversible. While ischemia above 2 hours, bile duct epithelial necrotic shape was significant. The obvious, hepatic necrosis was multifocal, flake, irreversible damage. Histological change also confirmed that 2 hours may be maximum security limitation of rabbit tolerance intrahepatic bile duct flow blocking under normal temperature.

Objective To evaluate the feasibility of using corrected body weight to set the tide volume for mechanical ventilation during general anesthesia in obese patients.Methods Ninety-six ASA physical status Ⅰ or Ⅱ obese patients,with a body mass index of 28-44 kg/m2,scheduled for elective extremity surgery under general anesthesia,were divided into 3 groups (32 cases of each group) by random digits table method:tide volume based on actual body weight group (group A),tide volume based on ideal body weight group(group B),and tide volume based on corrected body weight group(group C).The pulmonary function of all patients was normal.The patients were endotracheally intubated and mechanically ventilated after induction of anesthesia.According to the corresponding body weight,the initial tide volume was set based on 8 ml/kg in each group(respiratory rate:15 bpm).At 10 min after start of mechanical ventilation,peak airway pressure (Ppeak),airway plateau pressure (Pplat),airwayresistance (Raw) were recorded.Arterial blood samples were collected at 30 min of mechanical ventilation for blood gas analysis and arterial blood oxygen partial pressure (PaO2),arterial blood carbon dioxide partial pressure (PaCO2) and the patients requiring readjustment of tide volume were also recorded.Results The level of Ppeak,Pplat,Raw in group B and group C were significantly lower than those in group A[(15.3 ± 1.8),(18.5 ± 2.6) cmH2O (1 cmH2O =0.098 kPa) vs.(23.2 ±3.3) cmH2O; (11.5 ± 1.6),(14.3 ± 1.4) cmH2O vs.(17.6 ±2.7) cmH2O; (10.8 ± 1.7),(12.5 ± 2.6) cmH2O/ (L·s) vs.(16.8 ± 3.0) cmH2O/ (L·s)],and the level of PaCO2 in group B and group C was significantly higher than that in group A [(48.8 ± 3.1),(40.2 ± 2.3) mmHg (1 mmHg =0.133 kPa) vs.(28.6 ± 3.8) mmHg],there was significant difference(P ＜ 0.01).The level of PaO2 and oxygenation index in three groups had no significant difference (P ＞ 0.05).There were no patients requiring readjustment of tide volume in group C,however,93.8％ (30/32) patients required readjustment of tide volume in group A and 81.2 ％ (26/32) in group B,there was significant difference (P ＜ 0.01).Conclusion Corrected body weight based on 8 ml/kg can be used to set the tide volume for mechanical ventilation during general anesthesia in obese patients with normal pulmonary function.

We experienced women's helpless plight of domestic violence and extramarital affairs through the data of survey and case records in Women's Federation.Women in modern society are still experiencing domestic violence from their husbands' abuse and spiritual betrayal that often can't be solved in time.All these cases fully reflected neglect of females and unfair treatment to women from social systems.According to the analysis based on realities,the above hurt women encountered in their lives goes against basic bioethical principles.Not only sufficient attention but also legal measures are required to promote the harmonious development of society.

China ; epidemiology ; Humans ; Incidence ; Mining ; economics ; Occupational Exposure ; Silicosis ; epidemiology

Objective To reveal the status quo and emerging issues of co-authorship in regional health informatization research community in China.Methods The terms or keywords describing and covering regional health informatization were used to search the most relevant literatures about the subject in CNKI,Wanfang database and PubMed.Software tools were used to extract bibliographic,Social network analysis (SNA);co-authorship,and co-word analysis were used in this study.Results ①11,482 articles with 16,449 authors in the period of 1984-2013 were found.Each publication has an average of 1.43 authors,and each author has 0.70 publications.The number of coauthored literature was 7741 (67.42 ％).Both production and collaboration have been growing steadily.② Coauthored knowledge network was build which composed by 150 high-yielding Authors.The largest component comprises 43 authors(28％,43/156).The intermediate centrality of 57 authors were above 0.③ 230 2-plexes were found,and 65 2-plexes scale was 4 and over;and there was overlap among them.There were extensive cooperation between the military institutions,a large number of regional health information technology research talent were found in army research institutes..Cohesive subgroups density showed an E-I index=-0.901,which indicated that factionalism was comparatively weaker in this field,and the relationship tended to occur among subgroups.④ Cooperative network was established between the provinces and municipalities.Beijing,Guangdong,Jiangsu,Hubei were the core area.⑤ The average distance between the author=3.155,and it consistent with the small-world characteristics.⑥ The largest component of the network research can be summarized into three categories:HIS-related research,electronic medical records related research,and regional health informatization related research.Conclusions Although such collaboration is growing steadily,the collaboration behavior about regional health informatization study needs to be enhanced.Policy makers and researchers can refer to the relevant information and promote cooperation,improve the capacity of regional health information research and construction.

By means of literature review,the paper made a comparative study of key development projects of healthcare information in China over the last decade,in terms of their project characteristics,economic environment,development entity,investment and compensation practice,development strategy,coverage,experience and promotional values.Setbacks identified include the following:discrepancy in regional development stages of healthcare information; successful pilots are limited to scientific research samples; lack of regional models; systems separation; poor continuity and coordination; waste and insufficiency of resources in the investment and construction among others.The authors recommend a better exchange of experiences in building the regional healthcare information service platforms,greater investment,better compensation mechanism,better top-tier design,and maximized coverage within reach of supervision and technology.

Objective To study the disinfection efficacy of c ompound disinfectant of peracetic acid. Methods Suspended liqu id quantitative sterilization test and metal corrosion test were carried out wit h different concentrations of disinfectant compound. Results T he killing rate of Bacillus subtilis var.niger spores e xposed to peracetic acid 500 mg*L-1 or available chlorine 300 mg*L-1 for 15 minutes was 99.94% and 97.91% respectively, while that of the spores e xpos ed to the compound disinfectant containing both of them reached 100%. The influ ence of organic substances on the bactericidal efficacy of this compound disinfe ctant was less than that on the bactericidal efficacy of the single ingredient. The corrosive effect of the compound disinfectant on the metals was milder than that of peracetic acid, but heavier than that of dichlorodimethylhydantoin. Conclusions Disinfectant efficacy of compound disinfectant increase s clearly, while metal corrosiveness decreases.

The concept and methods of evidence-based medicine(EBM)has been evolved to impact almost all fields of health care and policy since it first appeared in 1992.but in the field of dentistry or stomatology,many problems remain to be solved in carrying out EBM.The necessity and feasibility of implementing evidence-based dentistry education in China were discussed in this paper for chnical evidence-based decision making and clinical research.The contenk teaching approach and accreditation tools for EBM in dental education were also proposed.

A comparison is made on the healthcare systems,economy,informationization environment,developers,investment and compensation mechanisms in nine countries featuring early startup,rich experiences,and relatively higher ratio of success in their development projects.This lead to a discussion focusing on the construction steps and development strategies for regional health informationization,and an analysis of the present regional health informationization overseas,common measures taken,and key factors for successful regional health informationization.Based on these,recommendations were made on development of regional health informationization compliant to China's circumstances.

The traditional discipline-centered curriculum design can neither keep up with developments of modern medical science nor reach requirements of the education reform in the new century.Since 2011,College of Stomatology in School of Medicine in Shanghai Jiao Tong University had developed ‘ disease oriented integrated curriculum system reform’ for students of long-term stomatology education.In view of the problems existing in the original curriculum system,the integrated curriculum system was set up by coalescing clinical medicine curriculum according to the related systems and oral medicine curriculum according to the developmental rules of diseases.Lectures were combined with discussion classes in the reform and performance appraisal system was changed from simplex judgments into comprehensive evaluations.At last,further considerations of promoting the reform based on the practice were proposed.