By analyzing the present defects in the management of medical consumables which include lagged management model,nonstandard storage names of medical consumables and bad traceability of the implanted medical products,this paper puts forward some corresponding improvement measures,such as changing the management model of medical consumables,standardizing the storage names of medical consumables and establishing information management system for tracing the implanted medical products,so as to realize scientific and appropriate management of medical consumables.

Objective To explore the clinical features of sev er e aplastic anemia (SAA) patients with chronic hepatitis B virus (HBV) infection.Methods 737 SAA cases newly diagnosed in the institute of Hemat ology and Blood Disease Hospital,CAMS in recent 13 years (1991 ~ 2003) were anal yzed.The ratio of SAA patients with chronic hepatitis B (21 cases,group Ⅰ) in them was investigated.A case-control study was undertaken to investigate the di fferences of clinical and laboratory features、therapeutic effectiveness and pro gnosis between SAA patients with chronic HBV infection \[the cases with chronic hepatitis B and those with antibodies to hepatitis virus B (23 cases,group Ⅱ )\] and SAA control group (42 cases,group Ⅲ ).Results ①The ratio of SAA patients with chronic hepatitis B in all SAA was 2.8%.②There was no significant difference of clinical features am ong them before treatment.③The recovery of PB counts、bone marrow hematopoiesis of group Ⅰ was slower than that of group Ⅱ and group Ⅲ after treatment.Th e percentage of CD8 + cells of group Ⅰor Ⅲwas significantly higher than that of group Ⅱ (P

Objective To explore the clinical efficacy of transcutaneous autologous bone marrow transplantation in the treatment of delayed union after internal fixation of limb fracture. Methods 41 patients with delayed union after internal fixation of limb fracture with informed consent in our hospital were divided into two groups by number table,20 patients in control group were treated with conventional therapy,21 patients in observation group were treated with transcutaneous autologous bone marrow transplantation,the effects and the occurrence of complications of two groups were compared and observed. Results In observation group,excellent healing in 13 cases(61.9%),good in 7 cases(33.3%),failure in 1 case(4.8%),and in the control group,6 patients(30.0%),11 cases(55.0%),3 cases (15.0%),the difference between the two groups was statistically significant(u=4.1934,P＜0.05);the complication rate of the observation group was 9.5%,compared with 15.0% of the control group,there was no significant difference(x2=0.034,P＞0.05). Conclusion Transcutaneous autologous bone marrow transplantation in the treatment of delayed union after internal fixation of limb fracture had better efficacy and less complication.

The dental clinical internship is the critical stage of combining theory and practice and changing the knowledge into ability for medical smdents through clinical practice.It should be based on the characteristics of oral medicine such as integrating the teaching content firstly,promoting the discussion teaching;then carrying the seminar teaching,including three steps,question-making,question-suspecting and question-solving Meanwhile,the training of scientific research and cultivate the innovative ability should be strengthened to cultivate students'creative ability by guiding studetents to refer to data.fill in the proposal of medical students and process an opening report,make medical records discussion and write professional summary and thesis.

Objective To find out the weakness in the emergency nursing for burst group accidents, and then building a normative nursing program which have included framework and 4 stages. Methods Using the method of Fish-Bone Drawing to analyzed the nursing courses in 22 burst accidents within the past 4 years retrospectively. Results After using the normative nursing program, nurses have known their own working targets and responsibility, which can apply the nursing care effectively and orderly. Conclusion The application of emergency nursing program is a kind of quick and proper nursing method, which can improve the patients' prognosis effectively.

OBJECTIVETo isolate the bibenzyl derivatives from the tuber of Arundina graminifolia and evaluate the anti-tumor activity of these compounds in vitro.

METHODThe constituents have been extracted by 95% alcohol and then isolated by column chromatography on silica gel and Sephedax LH-20. The structures were determined by UV, IR, NMR and MS spectral analysis.

RESULTSix constituents have been isolated, and their structures have been established as 2,7-dihydroxy-1-(p-hydroxylbenzyl)-4-methoxy-9, 10-dihydrophenanthrene (1), 4,7-dihydroxy-1- (p-hydroxylbenzyl)-2-methoxy-9,10-dihydrophenanthrene (2), 3, 3'-dihydroxy-5-methoxybibenzyl (3), (2E) -2- propenoic acid-3-(4-hydroxy-3-methoxyphenyl) -tetracosyl ester (4), (2E) -2-propenoic acid-3- (4-hydroxy-3- methoxyphenyl) -pentacosyl ester (5) and pentadecyl acid (6), respectively.

CONCLUSIONAll compounds except for 3 were isolated from the tuber of A. graminifolia for the first time. Compound 3 with bibenzyl ring opening exhibits stronger anti-tumor activity than that of compounds 1 and 2 with bibenzyl ring closing.

Antineoplastic Agents ; chemistry ; isolation & purification ; pharmacology ; Bibenzyls ; chemistry ; immunology ; isolation & purification ; Cell Line, Tumor ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Humans ; Magnetic Resonance Spectroscopy ; Orchidaceae ; chemistry

Objective To investigate the effect of coupled plasma filtration adsorption (CPFA) on plasma cytokines:TNF-α,IL-1β,IL-6,cellular immunity,blood lactate acid concentration,heart rate,respiration rate,oxygenation index,hemodynamics,blood cells counts,and prognosis in patients with multiple organ dysfunction syndromes (MODS).Methods This was a prospective,randomized clinical trial in 45 patients diagnosed as MODS.Patients were randomly assigned to hemoperfution with resin adsorption (HP) + continuous venous-venous hemofiltration (CVVH) group,CPFA group and CVVH group.The general clinical data,APACHE Ⅱ score,number of failure organ and previous mentioned biomarkers were documented.Blood samples were collected before and after blood filtration with any one of these procedures.The plasma samples were isolated and stored with frozen at-60 ℃.Data were statistically analyzed with SPSS 13.0 version software.Results In CPFA group,plasma cytokines,TNF-α、IL-1β、IL-6,decreased markedly after plasma adsorption for two hours (P ＜ 0.01);and plasma concentrations of IL-6 were further descended after subsequent CVVH for 10 hours (P ＜ 0.05).In HP + CVVH group,plasma cytokines,TNF-α、IL-1β、IL-6,decreased markedly after HP (P ＜ 0.01),and plasma concentrations of IL-6 were further descended after subsequent CVVH for 10 hours (P ＜ 0.05).In CVVH group,plasma cytokines,TNF-α、IL-1β、IL-6,decreased after CVVH for 12 hours (P ＜ O.05).Blood lactate acid concentration,heart rate,respiration rate,oxygenation index,T-lymphocytes subgroups (CD3 +,CD4 +,CD8 +,CD4 +/CD8 + ratio),clinical symptoms were improved and dose of vasoactive agent was reduced in the patients of three groups without differences among them.The counts of red blood cells,white blood cells and platelets after CPFA and CVVH showed no significant changes.There was no significant difference in blood cell counts between CPFA and CVVH groups.After HP + CVVH,there was a trend of decrease in platelet count (P ＜ 0.05).Platelet counts were significanfly higher in patients treated with CPFA and CVVH group than those in patients treated with HP + CVVH group (P ＜ 0.05).There were 6 patients died in HP + CVVH group,6 patients died in CPFA group and 5 patients died in CVVH group within 28days.Conclusions The comparison of efficacy of blood filtration among 3 modalities of HP + CVVH,CPFA and CVVH showed CPFA had higher capacity of Inflammatory medium scavenging than CVVH,and had less damage effect on blood visible component,especially on platelet compared with HP + CVVH.CPFA was an effective and safety modality in the treatment of the patients with multiple organ dysfunction syndrome.

Objective:To study the clinical features, therapeutic effects, survival time, and prognosis of patents with mantle cell lymphoma (MCL). Methods:Clinical data of 98 MCL patients admitted from January 2005 to December 2013 were retrospectively an-alyzed. Results:The median age was 61 years old, and the male-to-female ratio was 2.9∶1. Among these cases, 85 (86.8%) were in Ann Arbor stageⅢ-Ⅳ, 46 (46.9%) had bone marrow involvement, 25 (25.5%) had digestive tract involvement, and 53 chose R-CHOP as first-line treatment. The expected 3-year overall survival (OS) of these patients was only 61.4%. A total of 14 cases were treated with R-CHOP followed by ASCT. The expected 5-year OS was 92.3%, and the OS of the ASCT group was significantly higher than that of the R-CHOP group (75.5 months vs. 43.6 months, P=0.039). Elevated ESR,>60 years old, increased LDH level, B symptoms, and Ki-67≥25% were poor prognostic factors. Conclusion: Most patients with MCL were elder adults with bone marrow involvement. R-CHOP followed by ASCT had better clinical efficacy than conventional chemotherapy in the treatment of MCL.

Objective To explore efficacy and safety of simulated artificial pancreas in modulating stress hyperglycemia in critically ill patients. Methods A prospective randomized controlled study was performed. Seventy-two critically ill patients with stress hyperglycemia, aged 18-85 years, acute physiology and chronic health evaluationⅡ(APACHEⅡ) score over 15, two consecutive random blood glucose 11.1 mmol/L or higher, glycated hemoglobin (HbA1C) below 0.065, unable to eat food for 3 days after inclusion, or only accepting parenteral nutrition, admitted to intensive care unit (ICU) in Shanghai Punan Hospital of Pudong New District from January 1st, 2015 to June 30th, 2017 were enrolled. The patients were divided into three groups according to the random number table method, high-intensity group and low-intensity group were injected Novolin R (high-intensity group 2/3 dosage, low-intensity group 1/3 dosage) to modulate stress hyperglycemia by simulated artificial pancreas. Simulated artificial pancreas consisted of Guardian real time glucose monitoring system (GRT system), close-circle control algorithm and micro-pump;subcutaneous injection of Humulin 70/30 was applied to modulate stress hyperglycemia in humulin group. Real-time glucose levels of interstitial fluid in abdominal wall, equivalent to blood glucose levels, 10 minutes each time, were monitored by using of GRT system for all patients in three groups. Fasting serum levels of stress hormones including epinephrine and cortisol and insulin resistance index (IRI) were recorded within 24 hours after inclusion. Mean blood glucose, blood glucose variation coefficient, blood glucose target-reaching rate, blood glucose target-reaching time, hypoglycemia rate and 6-month mortality were measured. Twenty healthy adults from health administration department of the hospital were recruited as healthy control group. Results A total of 60 eligible critically ill patients were included in this study, each group with 20 patients. There was no significant difference in gender, age, APACHE Ⅱ scores among three groups. The levels of serum epinephrine, cortisol and IRI within 24 hours after inclusion in the three groups were significantly higher than those in healthy control group. The mean blood glucose levels of humulin group, low-intensity group, high-intensity group were decreased (mmol/L: 10.2±3.2, 8.4±2.6, 8.1±2.2), the blood glucose target-reaching rate were increased [40.2% (3 295/8 196), 71.1% (5 393/7 585), 80.4% (6 286/7 818)], the blood glucose target-reaching time were shortened (hours: 49.1±5.8, 24.6±4.6, 17.5±4.2), the hypoglycemia rates were increased respectively [1.3% (108/8 196), 2.8% (211/7 585), 4.0% (313/7 818)], with statistically significant differences (all 1 = 0.000). There was no significant difference in blood glucose variation coefficient and 6-month mortality among three groups [blood glucose variation coefficient: (29.4±3.7)%, (28.5±5.3)%, (26.1±4.6)%, 6-month mortality: 55.0%, 45.0%, 40.0%, all 1 > 0.05]. Conclusions Simulated artificial pancreas could effectively and safely modulate stress hyperglycemia in critically ill patients, high-intensity modulation could bring about better efficacy in the regulation of hyperglycemia. High-frequency blood glucose monitoring by using GRT system could promptly identify hypoglycemia and help it to be corrected.