By analying the relationship between the construction of the periodical and the management of the medical quality, the author explained the positive effect of strengthening the former on level raising of the latter, She also proposes that the value of the periodical can be raised by the quality construction including superiority orientation and creativity development. In this way we will raise the additional value of the management of medical quality and provide a high-level information platform for the quality mangement of hospital.

This paper reviewed the common ethical issues in oncology drug clinical trials implementation of one hospital, such as the auditing and implementation of research protocols were not strict, the quality of research-ers needed to be improved, the hardware facilities for drug clinical trial was lacking, the informed consent signature was not standard, and the professional quality control was lacking. After corresponding countermeasures had been taken, such as the strict examination of research programs, strengthening the research team construction, taking the focus of GCP and SOP training, equipping hardware facilities for drug clinical trials, standardizing of ICF signa-ture, and the joint implementation of the quality control in hospital and departments, the researchers′ professional quality was further improved, which established a good foundation for better implementation of the drugs clinical tri-als and protection of the participants′interests.

ObjectiveTo investigate a new way to prevent hyperacute rejection (HAR) during liver xenotransplantation through blocking the xenograft with recipient blood serum before transplantation.MethodsTwenty guinea-pig (GP) and Sprague-Dawley (SD) rats were pair-matched as donor and recipient randomly.Before transplantation,blood serum collected from other SD rats was inactivated at 45 ℃ in water bath for 30 minutes.Guinea-pig donor livers from experimental group ( n =10 ) were pre-perfused by 0.1％ solution of this blood serum,and donor livers from control group (n =10) were treated by Ringer solution.Then orthotopic liver xenotransplantations were performed by the modified two-cuff technique immediately.Liver morphology changes and survival rate and time of recipients were observed,and histopathological lesions were detected by HE staining,and liver ALT level was evaluated.ResultsThe operation time and anhepatic phases between two groups were not different significantly ( P ＞ 0.05 ).The survival rate of recipients from experimental group was higher,and its survival time was longer than that of control group significantly (P ＜ 0.01 ).The liver histological changes such as thrombosis and interstitial bleeding in experimental group was less severe than that in control group (P ＜0.01 ).The level of ALT in blood serum of rats from experimental group were lower than that from control group significantly ( P ＜ 0.05).ConclusionsThe results suggested that blocking the donor graft with recipient blood serum inhibits HAR during liver xenotransplantation.

OBJECTIVETo evaluate clinical results of early total care (ETC) treatment for elderly patients with intertrochanteric femur fractures.

METHODSClinical data of 106 elderly patients with intertrochanteric fracture treated from January 2012 and February 2015 were retrospectively studied. According to whether receiving the early total care mode, the patients were divided into 2 groups, 34 cases were diagnosed and treated with early total care pattern (ETC group), including 14 males and 20 females with an average age of (74.88 ± 4.38) years old ranging from 70 to 86. According to Evans types, 4 cases were type I, 5 cases were type II, 13 cases were type III, 11 cases were type IV, 1 case was type V. Seventy-two patients were treated with conventional trauma method (conventional group), including 35 males and 37 females with an average age of (74.46 ± 3.63) years old ranging from 70 to 85. According to Evans type, 8 cases were type I ,13 cases were type II, 25 cases were type III, 25 cases were type IV, and 1 case was type V. All fractures were treated with proximal femoral nails anti-rotation (PFNA). Operative time, hospital stays, leaving bed time, complications, cases of death at 1 year after operation, postoperative Harris score at 12 months were observed and compared.

RESULTSAll patients were followed up, the time of ETC group ranged from 9 to 18 months with an average of 13.29 ± 1.51, and the time in conventional group ranged from 12 to 16 months with an average 12.93 ± 1.15, while there was no significant difference between two groups in time of following-up (t = 1.368, P = 0.174). There was no significant meaning in cases of death between ETC group (2 cases) and conventional group (8 cases). Three cases occurred complications in ETC group, and 20 cases in conventional group,there was obvious meaning between two groups (χ² = 0.739, P = 0.318). Operative time,hospital stays,leaving bed time in ETC group respectively was (2.03 ± 0.67) d, (15.41 ± 2.87) d and (3.62 ± 0.74) d; while in conventional group respectively was (4.17 ± 1.59) d, (20.11 ± 4.24) d and (5.35 ± 1.22) d; there were significant differences between two groups in operative time, hospital stays, leaving bed time. Postoperative Harris scores at 12 months in ETC group was (82.32 ± 4.56), and (79.24 ± 5.52) in conventional group, there was obvious meaning between two groups (t = 2.833, P = 0.006).

CONCLUSIONETC pattern is a novel method for diagnosis and treatment of intertrochanteric femur fractures in elderly, it could shorten operative time, hospital stays, leaving bed time, decrease complications and promote recovery of function.

Aged ; Aged, 80 and over ; Female ; Femur ; injuries ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip Fractures ; surgery ; Hip Joint ; surgery ; Hospitalization ; Humans ; Male ; Operative Time ; Postoperative Care ; Retrospective Studies

OBJECTIVEto determine the effects of survivin antisense oligonucleotide (ASODN) on the expression levels of survivin mRNA and human mucoepidermoid carcinoma cell line (highly metastatic Mc3) apoptosis and to explore the feasibility of survivin gene as the mucoepidermoid carcinoma therapeutic targets.

METHODSthe survivin ASODN was designed and synthesized and then respectively transfected into Mc3 cells. The morphological changes of the Mc3 cells were observed 24, 48 and 72 h after transfection by inverted microscope and the apoptosis rate detected by flow cytometry. Methyl thiazolyl tetrazolium (MTT) assay was used to detect the effect of the transfection on cell poliferation, terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) method for analysis of apoptotic index, and semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) to detect the expression of survivin.

RESULTSin survivin ASODN transfection group, there was less Mc3 cells than in other groups. The suspended cells dropping from the wall increased and showed typical apoptotic changes and time-dependent. Mc3 cell apoptosis rate in survivin ASODN transfection group transfected for 24, 48, 72 h was 12.96%, 14.43%, 22.69%, respectively, which were significantly higher than in other groups (P < 0.01) and time-dependent (P < 0.05). The inhibitory rate of Mc3 cells in survivin ASODN transfection group was 22.35%, 39.04%, 43.46%, which were significantly higher than other groups (P < 0.01) and time-dependent (P < 0.05). The apoptosis index (AI) of Mc3 cells in survivin ASODN transfection group was 11.038%, 12.172%, 18.900%, significantly higher than other groups (P < 0.01) and time-dependent (P < 0.05). The survivin mRNA levels in Mc3 cells were 0.739 ± 0.008, 0.668 ± 0.007, 0.500 ± 0.006, and the relative inhibition rate in these cells was 18.21%, 26.06%, 44.82%, significantly lower than other groups (P < 0.01) and time-dependent manner (P < 0.01).

CONCLUSIONSsurvivin ASODN could inhibit the proliferation of Mc3 cells and induce the apoptosis of Mc3 cells. It also can inhibit the expression of survivin mRNA. Survivin can be used as a gene therapy targets for mucoepidermoid carcinoma.

Apoptosis ; Carcinoma, Mucoepidermoid ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; Gene Targeting ; Humans ; Inhibitor of Apoptosis Proteins ; genetics ; Microtubule-Associated Proteins ; Neoplasm Proteins ; Oligonucleotides, Antisense ; RNA, Messenger ; Salivary Gland Neoplasms ; metabolism ; Transfection

Objective To evaluate the effect of liver transplantation(LT)on the prognosis in patients with intrahepatic cholangiocarcinoma(ICC).Methods A retrospective analysis was performed on 11 consecutive patients with ICC who underwent LT between October 2003 and November 2008 at our institution.The overall and disease-free survival rates were calculated by the Kaplan-Mayer method.Results The median survival time Was 9.0 months(2.5-53 months).The 1-,2-,3-and 4-year disease-free survival rate and overall survival rate of all the patients were 51.9%、51.9%、51.9%、51.9%and 50.5%、50.5%、50.5%、50.5%,respectively.The perioperative mortality and the recurrence rate were 0 and 43.5%,respectively.The survival rate and disease-free survival time of patients with recurrence were 2.5-10 months(mean 7.5 months)and 1-8 months(mean 3.8 months).Conclusions The prognosis of LT for ICC is rather poor.ICC patients with lymph node metastasis.vascular or bile duct invasion is contraindicated for LT.

Ninety six female patients with chronic renal failure were randomly allocated into combination group (n =48) and control group (n =48).In combination group patients received both kidney transplantation and hematopoietic stem cell infusion,in control group patients underwent kidney transplantation only.The results showed that chronic rejection in the combination group was lower than that in the control group [2％(1/48)vs.17％ (8/48),P＜0.05)].The 1-,3-,5-and 10 y-survival rates of kidney in the combination group were 98％ (47/48),94％ (45/48),83％ (34/41) and 9/17,respectively,those in control group were 98％ (47/48),90％ (43/48),76％ (31/41) and 7/17,respectively.Infusion of donor hematopoietic stem cells can augment chimerism in early postoperative period and significantly reduce the rate of graft rejection,which is beneficial for the quality of life of the recipients.

Objective To analyze the occurrence of the complications after percutaneous endoscopic lumbar discectomy (PELD) for lumbar disc herniation or stenosis,and to reveal the effective prevention methods.Methods Retrospectively analyzed the clinical data of 568 cases who undertaken PELD,and all the related complications,possible causes,prevention and treatment methods were analyzed.Results There were 24 cases of complications occured in all the 568 cases treated with PELD,and the gross incidence rate was 4.23％,including 4 cases of dural laceration(0.70％),3 cases of hemorrhage of intravertebral vein plexus injury(0.53％),6 cases of postoperative wound pain (1.06％),8 cases of postoperative recurrence (1.41％),1 case with persistent symptoms after surgery (0.18％),2 cases of postoperative paresthesia(0.35％).Conclusion PELD is a minimally invasive surgery with high security and low incidence of complications.The effective preventions including careful decision-making,elaborate operation,and precise identification of the anatomical abnormality.

This study aimed to report the clinical characteristics and COMP gene mutation of a family with pseudoachondroplasia (PSACH), a relatively rare spinal and epiphyseal dysplasia that is inherited as an autosomal dominant trait. Clinical information on a 5-year-2-month-old PSACH child and his parents was collected and analyzed. Diagnosis was confirmed by PCR amplification and direct sequencing of all the 19 exons and their flanking sequences of COMP gene, and the mutation was further ascertained by cloning analysis of exon 10. The child presented with short and stubby fingers, bow leg, short limb dwarfism and metaphysic broadening in long bone as well as lumbar lordosis. A mutation c.1048_1116del (p.Asn350_Asp372del) in exon 10, inherited from his father who did not demonstrate any phenotypic feature of PSACH, was detected in the child. PSACH was diagnosed definitively by means of COMP mutation analysis, on the basis of the child's clinical and imaging features. The non-penetrance phenomenon of COMP mutation was described for the first time in PSACH.
Achondroplasia ; genetics ; Cartilage Oligomeric Matrix Protein ; genetics ; Child, Preschool ; Cloning, Molecular ; Humans ; Male ; Mutation

Objective To explore the applied value of electroencephalogram (EEG) in assessment of psychiatric impairment among patients with mental disorders due to traumatic brain injury.Methods According to the ICD-10,a total of 271 subjects were enrolled and assessed with the criterion of mental disorders due to traumatic brain injury.Activity of Daily Living Scale (ADL),Functional Activities Questionnaire (FAQ) and Social Disability Screening Schedule (SDSS) were used to evaluate the severity of patients.All the participants were tested by Wechsler Adult Intelligence Scale (WAIS) and examined by EEG.Results Totally 215 patients accomplished the study.The results of Glasgow Coma Scale (GCS),the severity of craniocerebral injury and the scores of FAQ,SDSS and ADL showed significant difference among the patients with different severity of EEG (P＜0.05).The grades of psychiatric impairment showed significant difference among the patients with different abnormal EEG (P＜0.05).Conclusion EEG can reflect the severity of craniocerebral injury,assist evaluate the social function and activity of daily living of patients with mental disorders due to traumatic brain injury,and distinguish the mild psychiatric impairment grades,which suggest that EEG has a certain reference value in the assessment of psychiatric impairment.