Objective To investigate the occurrence of intraoperative occupational exposure to blood among sur-geons in a hospital,so as to make effective precaution measures.Methods Combined with questionnaires,the mo-nitoring data of occupational exposure to blood among surgeons from June 2011 to June 2013 were analyzed statisti-cally.Results A total of 49 surgeons sustained 115 times of occupational exposure to blood,including 42 times (36.52%)in general surgery surgeons,36 (31 .30%)in orthopedic surgeons,31 (26.96%)in obstetrics and gyne-cology surgeons,and 6(5.22%)in urinary surgery surgeons.The main occupational exposure were sharp injuries (n=71 ,61 .74%),blood and body fluid splashing were 44 times (38.26%);the top two exposed sites were hands (49.57%)and faces (17.39%).88.70% of exposed cases were given emergent treatment,and 55.65% of exposed cases were reported.The follow-up found no surgeons were infected after the prompt and correct treatment. Conclusion Surgeons are at high risk of occupational exposure.Occupational precaution should be strengthened, occupational awareness and ability of HCWs should be enhanced,and post-exposure treatment should be improved.

Objective To study the set-up errors by CBCT in IMRT with two different immobilization techniques for thoracic and abdominal tumors.Methods Sixty patients with thoracic and abdominal tumor were included in this study and separated into study group and the control group.The study group were immobilized with carbon fiber holder,vacuum bag and thermoplastic mask.The control group were immobilized with carbon fiber holder and thermoplastic mask.CBCT scan and auto-match online were regularly performed before the treatment.The setup of left-right(x),superior-inferior(y),anterior-posterior (z) were received.The value of the Mptv was calculated,meanwhile.The grouped t-test of was carried out between these two methods.Results The shift errors in x-,y-,z-dimension of the study group were (0.32 ± 2.58) mm,(-0.40 ± 3.89) mm,(-0.75 ± 2.43) mm.The Mrrv were 5.60 mm,6.08 mm,6.32 mm.The translation set-up errors in x-,y-,z-dimension of the control group were(0.62 ±3.60),(2.44 ± 4.93),(0.66 ±2.85) mm,respectively.The MPrv were 8.07,10.63,6.90 mm,respectively.The t-test value were t =-0.78,-5.11,-4.22,P =0.440,0.000,0.000,respectively.Conclusions The immobilization techniques with carbon fiber holder,vacuum bag and thermoplastic mask would be better than the techniques without the vacuum bag in reducing the setup errors.

Wound healing results in a scar formation, especially in deep skin injury. As a result of injury in the subcutaneous tissue and skin, scar formation is coupled with surgical operation. Improvement in the knowledge about the pathological mechanism and prevention of scarring would help clinicians to better deal with postoperative care and improve the satisfaction of patients. This review put emphasis on discussing the process of scar formation after surgery and the positive factor in this process. And furthermore, This review presented primary interventions with certain therapeutic effect.

Aim To study influence of PTEN inhibitors ( PIC) on high glucose induced endothelial cell senes-cence Methods ( 1 ) HUVECs were cultured in ECM medium. Cell viability was determined by CCK-8. Cells were randomly divided into control group ( C ) , high glucose group ( HG ) , high glucose +10 nmol · L-1 PIC group ( HG +10 nmol · L-1 PIC ) , high glu-cose+100 nmol · L-1 PIC group ( HG +100 nmol · L-1 PIC) . Cell apoptosis was examined by flow cytom-etry. Senescence Detection Kit was performed by SA-β-gal Cytochemical staining. The expression levels of genes and protein ( p16 and Pten ) were detected by real-time PCR and Western blot. Results The prolif-eration rate was markedly decreased in HG group com-pared with C group, and this phenomenon was reversed by PTEN inhibitors . Cell apoptosis was significantly increased in HG group compared with C group, and a-gain these changes were blocked by PIC. The expres-sion levels of genes ( PTEN) were significantly higher in HG group compared with C group. The frequency of senescent ( SA-β-Gal-positive ) cells and the expres-sion level of senescence genes ( p16 ) were significantly higher in HG group compared with C group, and these changes were blocked by PIC. Conclusion These re-sults show that PTEN inhibitors ( PIC ) delays cellular senescence that is promoted under high glucose condi-tion.

Objective To evaluate the use of stapling anterior resection for rectal cancer. Methods Data of 1036 patients undergoing anterior resection for rectal cancer during 1983 to 2000 were reviewed retrospectively. Clinical results were compared statistically between patients who received stapling anastomosis (group A, n=652) and those did not (group B, n=384). Results The annual average stapler anterior resection increased from 5 cases per year (during 1983-1987) to 147 cases per year (1998-2000). The 0? Ⅰ? Ⅱ stage patients accounted for 53% in group A, and 62% in group B (P=0.004). There was higher percentage of patients in group A (66%) than in group B (39%) in which the distance from the lower edge of the tumor to anal verge was less than 8 cm (P

Objective To investigate the mechanism and clinical characteristics of rapid spontaneous resolution of acute subdural hematoma in children. Methods The clinical data of 9 children with rapid spontaneous resolution of acute subdural hematoma were retrospective analyzed. Results Subdural hematoma of three cases were completely dissolved within 8 h, while those of the other 6 cases were significantly reduced which were completely dissolved in 48-72 h. Conclusions Rapid spontaneous resolution of acute subdural hematoma in children is rare in clinical practice. The redistribution and dilution of hematoma and the anatomical characteristics of the children patient determine the possibility of hematoma dissipation. The conservative treatment can get a good prognosis.

Objective To identify the pmgnesfic factors influencing the recurrence and metastasis of adenocarcinoma of the ampulla of Vater after panreaticoduodenectomy. Methods A retrospective study was carried out on the clinical manifestation, pathological behavior and survival data in 101 patients with Vater's ampullary adenecarcinoma receiving pancreaticoduodenectomy from Jan 1980 to Dec 2003. Results According to TNM system, there were 42 cases (41.6%) of stage Ⅰ, 32 cases (31.7%) of stage Ⅱ, 27 cases (26.7%) of stage Ⅲ. During postoperative follow-up period [ median, 46(2-192) months] 25 patients (24.8%) suffered from recurrence or/and metastasis with the median recurrence time of 20 (2-93) months, among which there were 11(10.8%) cases of local recurrence and 20 (19.6%) cases of distant metastasis. The differences were statistically significant between the patients with recurrence or/and metastasis and those without in the following parameters: tumor size larger than 2 cm (64% vs. 39%, X2=4.56, P=0.033), positive lymph node metastasis in the primary specimens (52% vs. 17%, X2=11.98, P=0.001), postoperative complications (51% vs. 20%, X2=7.50, P=0.006). Logistic regression showed only lymph node status (OR=5.14, P=0.0037) was independent factors of tumor recurrence and metastasis. The median non-recurrent time in those without lymph node metastasis was 49 (2-192) months, significantly longer than the median 32(12-152) months in those with metastasis (X2=5.43, P=0.0198, log-rank test). Conclusions Recurrent metastasis is the main problem in patients with ampullary adenocarcinoma after pancreaticoduodenectomy. The lymph node status is an independent prognostic factor.

Objective To investigate the postoperative complications, survival and the prognostic factors of surgical treatment of distal cholangiocarcinoma . Methods The clinical data of 23 patients with distal cholangiocarcinoma treated by operation in our department in recent 12 years were reviewed retrospectively. Results The persistent period of symptoms befor operation in patients without postoperative complications ( 1.29?0.23 months) was significantly longer than that in patients with complications (0.50?0.18 months) (P

Objective: To investigate the neural connections between Shenmen (HT7)-heart and the brain by observing the tracing viruses co-labeled brain nuclear groups after injection of the pseudorabies viruses (PRV), the reverse transsynaptic virus tracer carrying different fluorescent protein genes, into the myocardium and Shenmen (HT7) point, respectively.Methods: Pseudorabies virus 531 (PRV531) carrying the green fluorescent protein gene and pseudorabies virus 724 (PRV724) carrying the red fluorescent protein gene were injected into the left ventricular wall and Shenmen (HT7) point area of the left forelimb of six C57BL/6 mice, respectively. After 120 h, whole brain tissue was extracted under 4％ paraformaldehyde perfusion to prepare brain sections. Neuronal co-labeling with the tracing viruses was observed under fluorescence microscopy. Results: Co-labeled signals from the mouse ventricular wall and Shenmen (HT7) point region were found at all levels of the mouse central nervous areas, such as the cerebral cortex, hypothalamus, midbrain, pons, and medulla oblongata. The number of co-labeled neurons was higher in the primary motor area, the hypothalamic paraventricular nucleus, the subceruleus nucleus, and the paramedian reticular nucleus. Conclusion: There is a neural connection between Shenmen (HT7), the heart, and the brain, which may be most closely related to the autonomic nervous system.

Objective To study the imaging findings of hip involvement and to compare the sensitivity of radiography,CT,and MRI in the identification of hip involvement in patients with ankylosing spondylitis(AS).MethodsAnteroposterior radiography of the pelvis and MRI of hip were performed in 55 patients with AS.CT scan of hip was performed in 29 of 55 patients.T1-weighted,T2-weighted,short tau inversion recovery (STIR) and three dimensional balanced turbo field echo with water selective excitation (3D-BTFE-WATS) coronal sequences of hips were obtained in all patients,of which fat-saturated contrastenhanced T1-weighted sequence was performed in 24 patients.The imaging data of 55 patients were analyzed.The chi-square test was used to analyze the sensitivity in the identification of hip involvement among radiography,CT,and MRI.ResultsAmong 110 hips in all 55 patients,abnormal changes were detected in 13 hips by radiography,85 hips by MRI.The findings of radiography included bone erosions in 13 hips,joint space narrowing in 4 hips,syndesmophytes in 5 hips.MRI revealed bone erosive destruction in 31 hips,joint space narrowing in 4 hips,joint effusion in 80 hips,subchondral bone marrow edema in 32 hips,fat accumulation of bone marrow in 28 hips,enthesitis in 21 hips.Bilateral synovial enhancement was showed in 19 of 24 patients who underwent fat-saturated contrast-enhanced T1-weighted sequence.Of the 58 hip joints in 29 patients who underwent CT examination,not only did CT show all bone erosions detected by radiography and MRI,but CT revealed bone erosive destruction that were not identified by radiography in 10 hips and by MRI in 1 hip as well.Abnormal changes were detected in 10.3％ (6/58)by radiography,27.6％ (16/58) by CT,and 77.6％ (45/58) by MRI.The sensitivity of MRI in the identification of hip involvement is higher than that of radiography and CT ( x2 =53.22 and 29.08,P ＜ 0.05 ).In addition to chronic bone structural changes,MRI depicted acute inflammatory changes which could not be detected by radiography and CT.ConclusionsMRI can detect early acute inflammatory changes of hip joint that can not be showed by radiography and CT.Effusion of joint and synovial enhancement caused by synovitis are the most common MRI findings of the hip in patients with AS.