Medical records are an important carrier of clinical medical information. With the technique of the CD mirror, medical records saved in CDs via scanning are stored in the server of the CD mirror, thus enabling realtime visit, retrieval, search, browse and transfer, improving the environment of medical record storage, and enhancing working efficiency and the utilization of the records. At the same time, relevant statistical surveys and analyses can be conducted with the software of medical record control, rendering information control scientific and standardized and finding an effective channel for the further exploration and utilization of the resources of medical information.

To develop and validate a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the quantification of epirubicin hydrochloride (EPI) in rat plasma, daunorubicin hydrochloride was used as internal standard. The plasma samples were deproteinated with methanol, and separation was performed on a reversed-phase CAPCELL PAK C18 column (3.0 mm x 50 mm, 3 microm). The mobile phase contained methanol-0.1% formic acid (80:20). Detection was carried out by multiple reaction monitoring on a HP1200-6410 QQQ LC/MS system. Different preparations of EPI solution, EPI-LIP (EPI-liposome) and EPI-LTSL (EPI-thermosensitive liposome) was administered in rats by i.v with the same dosage (12 mg kg(-1)). The pharmacokinetic model and parameters were fitted and calculated by the DAS ver2.0 software. The calibration curve was linear in the range of 0.01-50 microg mL(-1). The limit of quantification was 0.01 microg mL(-1). RSDs of intra- and interbatch precisions were all less than 11.9%. The average extract recovery was 89.3% and 92.1%, respectively. The pharmacokinetics of EPI in rats with all preparations were fitted to three compartments, which all fast distributed and slowly eliminated. The t1/2 alpha, t1/2 beta, t1/2 gamma, AUC(0-infinity), and MRT(0-infinity) of EPI-LTSL group were 7.5, 1.3, 12.6, 12.9, 3.7 times those of EPI solution group; and 1.6, 1.4, 12.3, 2.9, 2.6 times those of EPI-LIP group. Moreover, the CL of the latter two groups was about 13.4 times of the former EPI-LTSL group. EPI-LTSL can significantly improve AUC and prolong the circulation time of EPI in rat plasma.

Objective:To estimate the pharmacokinetics for two solution types of propofol glycoside in-jections in rats .Methods:A high performance liquid chromatography-high resolution mass spectrometry ( HPLC-MS) was established for measuring propofol in rat plasma .Two kinds of propofol glycoside injec-tions were developed and intravenously administered to rats via tail vein , respectively , and a commercial-ly available propofol emulsion injection was intravenously administered as a control .Propofol plasma concentration-time curves were determined , and the pharmacokinetic parameters were estimated .Re-sults:HPLC-MS measurement was performed by using a quadrupole-orbit trap high-resolution mass spec-trometer on a C18 chromatographic column.The mobile phase consisted of water and methanol (20∶80, V/V) .The ion source was an atmospheric pressure chemical ion source , and the negative ion was used for detection with a scanning mode of selective ion monitoring in which m/z 177.127 4 was used for propofol and m/z 149.096 1 used for thymol as an internal standard .A linear correlation between con-centration and peak area ratio was constructed in the range of 50 μg/L-10.0 mg/L propofol.The limit of quantification was 50μg/L propofol .The average recoveries of propofol from plasma were in the range of 93.6% -101.1%, and intra-day or inter-day relative standard deviation for measurement was <14%.The pharmacokinetic results showed that the two kinds of propofol glycoside injections exhibited the same pharmacokinetic behavior .However, the clearance and area under curve values of propofol for the two propofol glycoside injections were evidently increased as compared with those for propofol emulsion injection, respectively.Furthermore, their apparent distribution volumes were increased as well .Never-theless, the propofol elimination half-life (t1/2) value of the newly developed propofol glycoside injections was the same as that of commercial propofol emulsion injection (approximately 1.5 h).Conclusion:The established HPLC-MS method can be used for measuring propofol concentration accurately in rat plasma . The clearance and distribution volumes of propofol glycoside injection are bigger than those of the propofol emulsion injection .

Objective To investigate the mechanism of the different levels of ciprofloxacin resistance in qnrA-containing transconjugants.Methods E. coli J53AzR as the recipient,4 qnrA-containing transconiugants were constructed by conjugation from 4 qnrA-carrying clinical isolates.MICs of the transconjugants were measured by E test.aac(6')-Ib-cr was detected by PCR,and qnrA mRNA expression level was determined by real-time RT-PCR.The promoter sequences of qnrA were amplified by PCR from qnrA-bearing plasmids and cloned into plasmid pKK232-8,then transformed into HB101.All promoter fragments were sequenced.Resuits The MICs of ciprofloxacin against 4 transconjugants demonstrated a 10-fold difference from 0.094 μg/ml to 1.000 μg/m1.Of 4 qnrA-bearing plasmids in E.coli J53,ciprofloxacin MICs of pHS4 and pHS5 were 0.094 μg/ml and 0.125 μg/ml,respectively;pHS3,which contained the aac(6')-Ib-cr gene as well,MIC was 0.25μg/ml;and pHS5,which had a high expression level of qnrA and the aac(6')-Ib-cr gene,MIC was 1.00μg/ml.The relative expression levels of qnrA mRNA in J53 pHS6 was 32.5,much higher than the other 3 transconjugants(from 1.0 to 2.5).The promoter in plasmid pHS6 was 12-fold stronger than that in the other 3 plasmids.Compared with pHS3,there was 7 bp(GTTAGCA)deletion between the transcription initiation site and the start of qnrA in pHS6.Conclusion Co-existence of qnrA and aac(6')-Ib-cr in a single plasmid and high level of qnrA expression can account for the different levels of ciprofloxacin resistance in transconjugants.

Objective To investigate the effects and the mechanisms of tissue factor pathway inhibitor（TFPI）on no-reflow（NR）after acute myocardial infarction（AMI）and reperfusion in rabbits.Methods Rabbits were randomly divided into sham operation group,saline control group and TFPI group.The model of NR after AMI and reperfusion was induced by ligating coronary artery for 60 minutes and reperfusion for 90 minutes.The expressions of interleukin-6（IL-6）,tumor necrosis factor alpha（TNF-α）and tissue factor（TF）were determined by immunohistochemistry.No-reflow area（NRA）was evaluated by thioflavine S staining.The ligation area（LA）and necrosis area（NA） were evaluated by Evans blue and triphenyltetra zolium chloride（TTC）staining.Results After 90 minutes of reperfusion,the levels of IL6 and TF in saline control group were all singnificantly higher than those of TFPI and sham operation group（P 0.05）.There was no statistical difference in the expression of TNF-α（P 0.05）.There was no statistical difference of LA between saline control group and TFPI group（P 0.05）,while NRA and NA were markedly reduced in TFPI group compared with saline control group（P 0.05,P 0.01）.Conclusion No-reflow happened after ligating coronary artery for 60 minutes and reperfusion for 90 minutes in rabbits.TFPI could reduce NRA and NA,and the thrombosis and inflammation might be involved in the mechanisms.

Objective:To investigate the clinical efficacy of extended hepatectomy for hilar cholangiocarcinoma (HCCA) of Bismuth-Cor-lette typesⅢandⅣ(the longitudinal invasion degree along the biliary system is the main criteria). Methods:The clinical data of 61 patients with HCCA of Bismuth-Corlette types III and IV admitted in the Department of Hepatobiliary Surgery of the First Affiliated Hos-pital of Bengbu Medical College from January 2008 to May 2015 were analyzed retrospectively. Among the 61 cases, 22 underwent hepatectomy with half or over half of the liver removed or hepatic caudate lobectomy (regarded as the extended hepatectomy group), whereas 39 cases underwent irregular hepatectomy on the hepatic hilar region (regarded as the limited hepatectomy group). Results:Compared with those in the limited hepatectomy group, the patients in the extended hepatectomy group underwent longer duration of operation and experienced more bleeding during the procedure. The complication incidence rate for the extended hepatectomy group was lower than that for the limited hepatectomy group. No patient died during the perioperative period in the extended hepa-tectomy group, whereas two patients died in the limited hepatectomy group. Moreover, R0 resection was performed on 21 cases in the extended hepatectomy group, with a resection rate of (21/22) 95.5%, and on 20 cases in the limited hepatectomy group (P<0.05), with a resection rate of (20/39) 51.3%. Actuarial 1-, 3-, and 5-year survival rates were 77.27%, 36.36%, and 13.64%, respectively, in the extended hepatectomy group, and 69.23%, 20.51%, and 1.64%, respectively, in the limited hepatectomy group (P<0.05). Conclusion:Extended hepatectomy for patients with HCCA of Bismuth-Corlette typesⅢandⅣcould effectively increase the resection rates of R0 and the survival rate. Meanwhile, the prognosis of patients could be improved.

Objective To compare the effectiveness of surgical procedures (devascularization,shunt and combined shunt and devascularization) in treating recurrent variceal bleeding and other complications in patients with portal hypertension.Methods A systematic literature search was carried out on patients with portal hypertension,and a Meta-analysis was conducted using Revman 5.3 software to evaluate the effectiveness of different surgical procedures on recurrent esophageal variceal bleeding,hepatic encephalopathy,operative mortality and survival rates.Results A total of 24 trials were finally selected using predetermined inclusion criteria.Meta-analysis showed there was no significant difference among the three operations on operative mortality (P ＞ 0.05).The rebleeding rate of the combined group was significantly lower than the devascularization group (P ＜ 0.05).The encephalopathy rate of the combined group was significantly lower than the shunt group (P ＜ 0.05),and the 1-year and 3-year survival rates of the combined group were better than the devascularization group (both P ＜ 0.05),but there were no significant difference in the 5-year survival rates between these two groups (P ＞ 0.18).The 1-year and 3-year survival rates were not significantly different between the combined and the shunt groups (both P ＞ 0.05).Conclusions Combined shunt and devascularization had better therapeutic effectiveness than either devascularization alone or shunt alone in patients with portal hypertension with a high rebleeding risk.There were no significant difference among the three surgical procedures in operative mortality.The survival rates of combined surgery were significantly better than devascrlarization alone.

Objective To construct a systematic evaluation model of the operation and management capacity of pub-lic hospitals,and to objectively and realistically assess the current status of the operation and management capacity of public hospitals.Methods The"input-process-output"framework was used to construct a systematic evaluation model for operation management capability.56 public hospitals at or above the secondary level were sampled to con-duct empirical research.Results The results showed that,operation management in current stage emphasized a"re-sult oriented"approach,with insufficient basic investment and unclear core activities.Increasing funding investment,strengthening hospital marketing,and improving output quality were the core tasks of operation management.The operation management were generally in the initial stage,and the overall ability was not strong.The ability advantages of tertiary hospitals were relatively prominent.Conclusion It recommended that public hospitals should focus on the five major elements of human resources,finance,information,systems and decision-making mechanisms to com-prehensively optimize operation management investment;precise core activities,and promote the modernization of the economic system by improving the efficiency of resource allocation;stimulate the potential of hospitals,medi-cal staff,and disciplines to improve the quality of comprehensive outputs.

Objective To study the effect of extended hepatectomy for hilar cholangiocarcinoma (HCCA) of the Bismuth-Corlette type Ⅲ and Ⅳ.Methods The clinical data of 73 patients with HCCA of the Bismuth-Corlette type Ⅲ and Ⅳ treated in our department from January,2008 to June,2016 were analyzed retrospectively.The extended hepatectomy group of patients consisted of 29 patients who underwent hepatectomy with half or more than half of the liver removed or/and combined with hepatic caudate lobectomy.The limited hepatectomy group consisted of 44 patients who underwent non-anatomical hepatectomy around the hepatic hilar region.Results Compared with the limited hepatectomy group,patients in the extended hepatectomy group had significantly longer operations with significantly more intraoperative blood loss.However,the complication rate was significantly lower than that of the limited hepatectomy group.There was no perioperative death in the extended hepatectomy group,while 3 perioperative deaths occurred in the limited hepatectomy group.The R0 resection rate was 93.1％ (27 of 29) for the extended hepatectomy group,while it was 54.6％ (24 of 44) for the limited hepatectomy group (P＜0.05).The 1-,3-and 5-year survival rates or the extended hepatectomy group were 81.4％,51.4％ and 19.3％,respectively while the corresponding rates for the limited hepatectomy group were 70.5％,24.4％ and 8.7％,respectively (P＜0.05).Conclusions After adequate preoperative radiological assessments on tumor resectability,and the residual liver volumes,with preoperative biliary drainage to improve liver function,extended hepatectomy effectively increased R0 resection and survival rates with improved prognosis for patients with HCCA of Bismuth-Corlette type Ⅲ and Ⅳ.

Objective:To evaluate the radiation dose to the injured persons in a radiological accident, provide the guidance on the diagnosis and treatment of radiation injury, and provide the basis for determination of the level of radiological accident.Method:Firstly, the air-absorbed dose rates at 206 locations surrounding a X-ray device were measured by using LiF (Mg, Cu, P) thermoluminescence detectors and self-made radiation field measuring frames. Secondly, the spatial distribution of radiation level was obtained by fitting the inverse square law between absorbed dose rate and distance, which is used as the basis of dose estimation. Finally, based on the actual working conditions of injured operators, a parameter calculation method was proposed for estimating hand skin absorbed dose.Results:The air-absorbed dose rate surrounding X-ray beam outlet was higher than 1.0 mGy/h. The maximum air-absorbed dose rate value in the space of within 200 cm outside X-ray beam outlet was 262 μGy/h and the minimum value was 2.1 μGy/h, 2 orders of magnitude higher than environmental background level. During normal operation, the total absorbed doses to the hand skin of two injured female operators were 36.9 and 16.9 Gy, respectively. During extreme operation, the hand skin-received total absorbed doses to the two operators were 85.2 and 38.9 Gy, respectively. Under the occupational health standard GBZ 106-2020, the two persons had acute radiation skin injury of grade Ⅲ or Ⅳ on their hands.Conclusions:The results of hand skin exposure doses provide effective support for diagnosis and treatment of radiation injuries and for the determination of radiological accident level. The method used in radiation field reconstruction and dose estimation mentioned in this study can provide reference for the treatment in the similar radiological accident.