Objective To reproduce a pulmonary carcinoma model by injecting VX2 tumor tissue block suspension into rabbits' lung,and to compare the result with that of injecting VX2 tumor cells suspension.Methods A total of 50 New Zealand white rabbits were divided into two groups randomly with 25 in each.The VX2 tumor tissue block suspension and cell suspension were injected respectively into the right lower lung of each rabbit in two groups.The growth and metastasis of tumor in the thorax were observed with CT scan.The general condition of the animals was observed as well.Results The pathological pictures of the VX2 tumors were the same in two groups.The ratio of successful transplantation was 100% in the tissue block suspension group,while it was 48% in the cells suspension group,a remarkable difference in the success rate of tumor transplantation was found between the two methods(P

Objective To investigate the expression and clinical significance of proapoptotic genes HtraA2 in acute myeloid leukemia.Methods 78 cases of AML patients were divided into newly diagnosed AML group,complete remission group and hard flag group,and another 25 cases treated at the same period were set as the control group.The boue marrow and peripheral blood samples were collected from all the groups for total RNA extraction and detection of expressed HtrA2.The HtrA2 expressions were compared among thc groups.Finally 17 patients were followed up for 1～56 months.Results The HtrA2 expression levels of 3 groups were significantly different (x2 =35.13,P ＜ 0.05),with the ratio of maximum to minimum values up to 68.76.There were no statistically significant differences in the relative expression of gcnes HtrA2 among the FAB type (F =0.004,P ＞ 0.05).HtrA2 gene expression after treatment was significantly higher than before treatment in the patients followed up (P ＞ 0.05).HtrA2 gene might affect the survival time of patients (Wald =4.979,P ＜ 0.05),but age and gender had no influence on survival states (Wald =2.426 and 0.833,P ＞ 0.05).Survival curve analysis showed that the median smvival time was 34.50 months in the patients followed up.Conclusion The expression level of HtrA2 can be beneficial for the diagnosis,treatment and prognostic evaluation of AML.

Objective To investigate the efficacy of dexmedetomidine-assisted topical anesthesia in patients undergoing bronchoalveolar lavage ( BAL). Methods Twenty-four ASA Ⅱ or Ⅲ patients in ICU, aged 24-64 yr, weighing 50-80 kg, scheduled for BAL, were randomly divided into 2 groups ( n = 12 each) : topical anesthesia group (group A) , topical anesthesia + dexmedetomidine group (group B) . In group A, 0.9% normal saline 5 ml was injected intravenously 30 min before operation, 2% lidocaine 5-10 ml was given via a tracheal tube or cannula 5 min before operation and then an increment of 2% lidocaine 5 ml was given using fibreoptic bronchoscope every 15-30 min as required (the total amount was within 20 ml) . In group B, dexmedetomidine 0.5-1.0 μg/kg was injected (time of injection≥ 10 min) followed by infusion at 0.1-0.5 μg·kg-1 ·h-1 and the topical anesthesia was performed as the method described in group A. The time of lavage, adverse reactions and adverse cardiovascular events were recorded. Blood samples were taken 20 min before lavage, 20 min after the start of lavage and 20 min after the end of lavage (T1-3 ) for determination of the concentrations of plasma catecholamine and serum cortisol. Results The incidences of adverse reactions and adverse cardiovascular events were significantly lower and the operation time was significantly shorter in group B than in group A ( P < 0.05). The concentrations of plasma catecholamine and serum cortisol were significantly higher at T2，3 in group A, while lower at T2，3 in group B than at T1 ( P < 0.05) . The concentrations of plasma catecholamine and serum cortisol were significantly lower in group B than in group A ( P < 0.05). Conclusion Dexmedetomidine-assisted topical anesthesia can be used safely and effectively in BAL.

Objective To analyze the short-term results of endovascular aortic repair (EVAR)for patients with acute type B aortic dissection and chronic renal insufficiency (CRI ).Methods Between February 2009 and December 2012,EVAR was performed in 30 patients with acute type B aortic dissection and CRI (CRI group).Consecutive 30 patients with acute type B aortic dissection whose renal function was normal during the same period was chosen as the control group (non-CRI group).All patients were within 14 days after onset,in which Marfan syndrome was excluded and diagnosis made by computed tomographic angiography (CTA) before the procedure.In 57 patients,EVAR was performed under looal anesthesia and associated procedures included insertion of a chimney stent in the left subclavian artery in 2 case and a bare metal stent in the renl artery in 2,In 3 patients,EVAR was done following right axillary artery-to-left axillary and left subclavian artery bypass with a Y-shaped graft under general anesthesia.Follow-up regimen included renal function and CTA at I month and 1 year postoperatively.Results Compared to the non-CRI group,patients in the CRI grup was significantly younger [ (44.7±13.2) years versus (53.7±16.2)years,P ＜0.05)and had a higher rate of perioperative complications (cerebrospinal ischemia,deterioration of renal dysfunction,and gastroenteral dysfunction) (16.7％ versus 3.3％,P ＜0.05 ),all of which resolved after surgical or medical treatment.One patient in CRI group was readmitted at 6 months for a redo EVAR to treat a new tear distal to the stent.At 1 month and I year postoperatively,no patients suffered from deterioration ofthe renal function,and their CTAs detected no apparent device deformation,alteration and endoleak,with remsrkable improvement in the blood supply of the aortic trie lumen and branches.Conchusion Satisfactory short-term results can be achieved with EVAR for patients with acute type B aortic dissection and CRI.At I month and 1 year postoperatively,no mortality or morbidity occumed such as endoleak,aortic rupture,neurologic and abdominal ischermia.

We are reporting in this article some analyzed data obtained from inspection and related information on current situations medical devices in use. Some ideas and suggestions are also proposed here on how to systematically and legally inspecting and monitoring medical devices in use.
Equipment Safety ; Materials Management, Hospital

This study was aimed to optimize the uniform design for effective constituents in water-soluble extractives D, E, F of traditional Chinese medicine (TCM) in Qi-Xue Bing-Zhi Fang (QXBZF) for the further validation of the ratio of different compatibility. A total of 100 SD rats were used in the study. Among them, 90 rats were given high fat feeding for 7 days. Then, stratified randomization was used. The rats were divided into the all-party group; D, E original prescription group; D, E optimized compatible group; D, E between optimized and original group; D, E optimized but anti-compatibility group; all-party group adding F; optimized compatible group adding F; QXBZF with mainly paeoniflorin accounted for 49.12% as component D, total flavonoids accounted for 30.0% as component E, total acids accounted for 32.07% in component F; the positive drug control group (Xue-Zhi-Kang, 0.108 g/kg); and the high fat model group. In addition, a blank control group (with normal diet) was set. Each group was treated with gastric perfusion according to drug compatibility proportion for 14 days. Rats were sacrificed to take blood samples for the detection of serum lipid, platelet aggregation, vasoactive substance, and inflammation level. The results showed that compared with the model group, the QXBZF D, E original prescription group and D, E optimized compatible group had significant decreasing effects on TC (P< 0.05). The lowest level of TC decreased by optimized compatible group was (3.49 ± 0.86) mmol/L. The all-party group, D, E original prescription group and optimized compatible group can inhibit the platelet with maximum aggregation rate effectively(P< 0.05, P< 0.01); while the D, E optimized but anti-compatibility group (with D, E inverse proportion) had no effect on it. All-party group and the D, E original group adding F had significant inhibition on IL-6 and IL-8 (P < 0.05, P < 0.01). The D, E original prescription group, D, E optimized compatible group and D, E between optimized and original group can ascend 6-Keto-PGF1α significantly (P< 0.05). ET-1 was decreased in the D, E optimized compatible group (P< 0.05). Other groups had no obvious effect on vascular active substances. It was concluded that different effects between the QXBZF D, E original prescription group and the D, E optimized compatible group were observed in action segment and strength. When F parts added, inhibitions of inflammation levels were enhanced at certain level.

Objective To investigate the expression and clinical significance of platelet activating factor [PAC]-1, CD62P and TPP hi severe sepsis. Method Patients with severe sepsis who were admitted into the EICU of Subei People's Hospital from April 2007 to March 2008 were included. Patients with severe sepsis (Group Ⅲ)were treated according to the treatment guidelines for severe sepsis, and were divided, according to their clinical records, into those who survived and those who died within 28 days of admission. Patients admitted during the same period with symptoms of infection but without severe sepsis were included as the General Infected Group (Group Ⅱ). A Control Group (Group Ⅰ) comprised patients who visited the hospital over the same period for physical examination or the healthy volunteers. The group members were all included randomly, and the gender and sex of patients in all three groups were similar. Patients with acute brain infarction, acute coronary syndrome,serious diabetes, hyperlipidemia, malignant tumor, leukemia, primary liver, renal and hematopoietic system dis-eases,long-term bedridden patients, pregnant women, and patients taking hormone treatment or hranunosuppres-sants were excluded from the study. Morning venous blood was collected and ELISA and Flow Cytometry performed on the fwst day of admission for Groups Ⅰ- and Ⅱ, and on the first, third and fifth day after admission for Group Ⅲ, to determine the TpP,PAC-1 and CD62P respectively; and the Marshall score was determined. Data were ana-lyzed by SPSS 12.0 software. For continuous variables, comparisons among groups were analyzed by ANOVA.Levene's and LSD test were applied to assess homogeneity. Bivariate test is applied to Correlation Analysis. P<0.05 was regarded as a statistically significant difference. Results There were a total of 20 patients each in GroupⅠ-and GroupⅡ, and 30 in Group Ⅲ; of these, 19 were classed as survivors and 11 died during the 28-day peri-od. On the first day of admission, there were no significant differences in PAC-1, CD62P or TpP expression between Groups Ⅰ- and Ⅱ(P>0.05); however, Group Ⅲ was significantly different compared with both Group Ⅰ and Group Ⅱ (both:P<0.05). The expression of PAC-1, CD62P and TpP tended to decline in the survivor group,and became normal with the treatment process, while the expression of PAC-1 ,CD62P and TpP in the patients who died remained high, and even increased significantly over time. On the first day, the expression of CD62P and TpP in the patients who survived and in those who died was not significantly different (P>0.05); on the third day,however, a significant difference appeared with values of (2.89±1.48) % vs. (5.04±2.57) % (P<0.01) for CD62P, and (5.24±2.22) mg/L vs. (9.20±1.93) mg/L (P<0.01) for TpP. The expression of PAC-1 was significantly different between the two subgroups on the first day, with values of (3.15±0.42)% vs. (5.30±.48)% (P<0.01). The Marshall score of the two groups showed similar changes. Correlation analysis showed that PAC-1, CD62P and TpP were significantly correlated with the Marshall score. Conclusions Platelet activation and microthrombosis existing in the early stage of severe sepsis work together in the early hypercoagulable state.They both play important roles in disease development and progression. The dynamic detection of CD62P and TpP is beneficial to the diagnosis and prognosis of severe sepsis.PAC-1 appears to hold a risk stratification effect, as pa-tients with high expression of PAC-1 in the early stage show poor prognosis. Therefore, PAC-1 could be used as a marker of severe sepsis and poor prognsis.

BACKGROUNDTo study the biological effects of multi-electrode radiofrequency ablation on pulmonary tissues of rabbits.

METHODSUnder the guidance of computer tomograph, electrodes were inserted into right lungs of New Zealand white rabbits and radiofrequency was performed. The biological effects were observed through CT image and microscopy.

RESULTSCoagulative necrosis was found immediately in ablation area after the procedure. On the 7th postradiofrequency ablation day, fibrous tissues appeared in the necrotic lesions. On the 30th postradiofrequency ablation day, bronchial and alveolar epithelium began to proliferate. Within 60 to 90 days after treatments, the necrotic lesions were almost replaced by normal pulmonary tissues. In group with electrodes into the right hilum, time for treating and initial impedance were significantly different from those with electrodes into the peripheral sites of the right-lower lobes (P < 0.01, P < 0.01).

CONCLUSIONSMulti-electrode radiofrequency ablation can be safely and effectivly performed in pulmonary tissue and cause coagulative necrosis within a certain extent.

We are reporting in this article some analyzed data obtained from inspection and related information on current situations medical devices in use. Some ideas and suggestions are also proposed here on how to systematicaly and legaly inspecting and monitoring medical devices in use.

BACKGROUNDTo observe the CT appearance and pathological changes of VX2 tumor in rabbit lung after radio-frequency ablation.

METHODSAfter VX2 tumor tissue suspension was injected into the lungs, the transplanted lung cancer models were established in 36 New Zealand white rabbits. Twenty-eight rabbits were treated with radio-frequency ablation, and another 8 rabbits without any treatment as control. The CT appearances and pathological changes were observed in different time intervals after the treatment in 14 rabbits out of experimental group. The survival periods of the rabbits were recorded in the rest 14 rabbits of experimental group and the control group respectively.

RESULTSCoagulative necrosis and cell apoptosis appeared in the tumor tissues after the ablation, and inflammatory cells were found in the lung tissues around the areas of ablation. Wadding shadows appeared in CT images after the treatment and disappeared with the inflammation vanished, but the tumor shadows ceased to increase. In the experimental group, tumor tissues were almost necrosed in the target areas of 21 rabbits, however, peripheral residual nests of histologically viable tumor were found in the target areas of the other 7 rabbits. The survival periods of rabbits in the experimental group and the control group were 38 days±3.4 days days and 26 days±2.8 days respectively (P < 0.05).

CONCLUSIONSRadio-frequency ablation may be an effective method in the treatment of lung cancer.