Humans ; Liver Failure, Acute ; etiology ; therapy

Objective To understand the present situation of therapeutic drug monitoring(TDM)on cyclosporine A(CsA) application in renal transplant recipients.Methods The clinical data of the first postoperative month of 50 renal transplant cases admitted to our hospital during May 2000 to March 2005 were collected and retrospectively analyzed.Results Total 50 cases(male∶female= 3∶1) had accepted the trigeminy of CsA,prednisone and azamun.The average initial dose and average maintenance dose for the male were higher by 59.94 mg/d and 52.00 mg/d than that for the female(P

Objective To measure the changes of enamel diameter and depth after Er :YAG laser irradiation .Methods 80 enam-el samples were randomly divided into two supergroups according to irradiation time (10 s and 20 s) ,each supergroup was randomly divided into 5 groups according to different irradiation energy (0 .5W ,1 .0W ,1 .5W ,2 .0W and 2 .5W) ,separately underwent the Er :YAG laser irradiation with different time and different energy .Observed and measured the diameter and depth of each pit with a stereoscopic microscope after irradiation .Results After 10 seconds irradiation ,the differences of enamel diameter between illumi-nate power 0 .5W and 1 .0W ,0 .5W and 1 .5W ,0 .5W and 2 .0W ,0 .5W and 2 .5W were statistically significant(P<0 .05) ,the differences of enamel depth between two groups were statistically significant (P<0 .05) eliminating 1 .5W and 2 .0W .After 20 sec-onds irradiation ,the differences of enamel diameter between illuminate power 0 .5W and 1 .0W ,1 .0W and 2 .0W ,1 .0W and 2 .5W were statistically significant(P<0 .05) ,the differences of enamel depth were the same to 10 seconds irradiation .Conclusion The diameter and depth of enamel were changed under the irradiation of different time and energy ,which was helpful to clinical treat-ment of enamel caries .

Objective To investigate the levels of IL-33 in the lung induced by Aspergillus fumigatus (A.fumigatus) exposure in bronchial asthmatic rats and the effects of dexamethasone.Methods Twenty-four Wistar rats were randomly and equally divided into group A (normal control),group B (asthma group),group C (A.fumigatus-exposed group),and group D (dexamethasone-treated group).B,C and D group were sensitized and challenged with ovalbumin (OVA) to establish asthmatic models.Then,group C and D were given A.fumigatus spores intranasally.Group D was pre-treated with dexamethasone during ovalbumin challenge.Group A was sensitized and challenged intranasally with normal saline as control.Airway hyperresponsiveness,eosinophils percentage and serum IgE levels were measured to confirm the establishment of asthmatic model.Expression of IL-33 in the lung were quantified by ELISA and qRT-PCR.Lung tissues and blood were plated on the potato dextrose agar (PDA) medium and cultivated for 24 h to measure the number of colony.Results Eosinophils percentage in bronchoalveolar lavage fluid (BALF),IgE levels in serum and IL-33 levels in the lung in group B and C were much more higher than in group A (P＜0.05),and the increasing range in group C was more obvious than group B.However,the changes of sRaw values in these groups had no statistical significance.Esosinophils percentage in BALF and IL-33 levels in the lung were significantly decreased (P＜0.05),and IgE levels in serum was slightly decreased (P＞0.05) in group D when compared with group C,but the ratio of A.fumigatus colonization in the lung was higher than group C.Conclusions Dexamethasone can inhibit the expression of IL-33 in the lung induced by A.fumigatus exposure in an asthmatic rat,but it also increases the risk of fungal colonization in the airway.Anti-IL-33 antibody treatment needs further research.

Objective To investigate the clinical features and treatment programs in children with Takayasu arteritis (TA) in order to improve awareness of the disease. Methods A retrospective study of hospi-talized children with TA in our hospital from Jan. 1999 to Dec. 2012 was performed. Results Between the 15 patients with TA, the ratio of male to female was 1∶2. The onset was from 14 months to 15 years old, with average age at (10 ±4) years old. It is according to (the European League against Rheumatism/the Pediatric Rheumatology European Society (EULAR/PRES) criteria for the diagnosis of TA. The most common clinical manifestations are hypertension, which occurred in 13 cases(87%), weak pulse or pulseless in 11 cases (73%), and heart failure in 10 cases (67%). About two-thirds of patients were diagnosed when the onset of heart failure occurred. The most common clinical type was type Ⅱ, which occrred in 9 cases (60%). Antihypertensive drugs, oral steroid and congestive heart failure controlling were the main treatment. Three patients with positive purifiedproteinderivative (PPD) test received anti-TB treatment. Three patients had vascular bypass surgery, one patient had percutaneous transluminal angioplasty. Conclusion TA may be life-threatening and progressive. Many patients are with advanced disease at the time of treatment, so the prognosis is generally poor. Early recognition is necessary to initiate appropriate therapy. The disease should be considered in patients with unexplained arterial hypertension or unexplained inflammatory syndromes without local signs.

Objective Good culture sense of patient safety among the hospital staff is in close relation with the improvement of medical quality and patient safety .The article was to provide evidence for the culture management of patient safety and related stud -ies.Methods We searched the main databases Pub Med , Chinese Bio-medical Literature Database , CNKI, Wan-Fang database with the key word safety environment,safety culture,safety approach,evaluate,assessment,situation analysis,analy-sis. Results 50 literatures were collected.The assessment tools could be divided into self-made questionnaire (13, 26%), im-proved questionnaire (16, 32%), chineselized foreign questionnaire (21, 42%).The main researchers (84%) and study objects (66%) were nurses.48 (96%) investigation and descriptive study were about patient safety culture;only 2 documents made compari-son before and after the patient safety culture cultivation . Conclusion The research of patient safety culture in our country is rising currently, while the development of assessment tools is still at exploration stage .The width and depth of related research should be fur-ther broadened .

Objective To study the cognition of scientific research integrity and know status of scientific research standard of nurses who had research experience so as to provide some evidence for nursing research integrity management.Methods A total of 296 nurses whose working years was more than 5years and who had delivered scientific research papers in 13 Grade A hospitals from 7 cities were investigated by self-designed questionnaires.Results More than 64.0％ nurses showed not appropriate or inappro-priate for those irresponsible research behavior.64.5％ nurses did not agree with the researchers to referring the research object situation for others,97.0％ nurses believed the research achievement should be objective.While nurses did not know the research standards well:only 56.1％ nurses knew the standard of submitting manuscript,and 20.6％ nurses knew research data collection,preservation and usage.Conclusions It is necessary to enhance the management of nursing research integrity through education and propaganda of the research standards,improving the scientific management system,increasing the research support for nurse scientific so as to promote the nursing research integrity.

Objective To explore the most suitable condition of influenza virus which was culturing on plateau region,and im-prove the effect of the separation of influenza virus.Methods The original specimens were respective inoculated in MDCK cells,by comparing CO2 percent concentration (5%,4.8%,4.6%,4.4%,4.2%),TPCK-pancreatic enzyme dosage (1,2,3, 4,5μg/m and 6,8,10μg/ml),inoculation amount (100,200,300,400,500μl),incubation time (48,72,96,120,144 h),inoc-ulation methods (adsorption,direct inoculated),and culture vessel(cells,6 orifice)that were influenced on influenza virus, the best culture conditions was determined.Hemagglutinatio (HA)method was used to detect the virus titers.Results Through the comparison,the HA titer of virus was in the highest titer with 6 orifice plate culture vessel,4.4% CO2 and 4.6% CO2 ,2μg/ml TPCK-pancreatic enzyme,300μl and 400μl inoculation amount,72h~96h of incubation time.Conclusion The optimal condition of the influenza virus cultured with the MDCK cell has been established in the laboratory on plateau region.

OBJECTIVE: To avoid the infection induced by the clinical application of total parenteral nutrition solution( TPN) . METHODS: The experience of quality control and etiological examination in the preparation and application of TPN for 62 patients in our hospital were analyzed retrospectively. RESULTS & CONCLUSION: The key to reduce the incidence of infection in the preparation and application of TPN is to keep the infection source under control.

We have discussed the current medical professional ethic education status in china regarding international students coming to china,and analyzed the problem and the reason fo it.Combing with the practical experience of ourselves,we try to explore how to perfect the above-mentioned situation.