Objective To compare the hemostatic efficacies of radial artery balloon and spinning hemostat in elderly patients after radial artery intervention.Methods Eighty elderly patients undergoing transradial coronary intervention were randomly divided into balloon and spinning hemostat groups,with 40 cases in each group.After operation,balloons and spinning hemostats were used for hemostasis,respectively.The two groups were compared in terms of hemostatic effect,comfort degree and incidence of complications.Results These was no difference in hemostatic effect between the two groups(P>0.05).The balloon hemostat group was better than the spinning hemostat in respect of comfort degree.The incidences of ischemia and vagal reflex in the balloon hemostat group were significantly lower than the spinning hemostat group(P<0.05).Conclusion The balloon hemostat for radial artery intervention is more suitable for elderly patients undergoing oral treatment.

OBJECTIVE:To evaluate the content validity and interrater reliability of the modified medication discrepancy tool (MDT). METHODS:According to the structure of MDT(English edition),the terms of MDT were modified,and 5 invited ex-perts used content validity indicator to test the content validity of MDT. The interrater reliability method was adopted to test the reli-ability of MDT. The interrater reliability was performed by 2 evaluators to same 20 research objects with modified MDT. RE-SULTS:Average item-level content validity index was over 0.800,and scale-level content validity index was 0.970. The item-level interrater reliability was between 0.667 and 1.000(P<0.01). The scale-level interrater reliability was 0.840(P<0.01). CONCLU-SIONS:The modified MDT has good content validity and interrater reliability,and can be used to evaluate discharged medication discrepancies in China.

Objective To define the MRI features of biliary postoperative disoders,so as to find its exact causes.Methods MRI informations of 41 patients with biliary postoperative disoders were retrospectively evaluated to find whether there were such disorders as biliary dilatation,stricture,cholangeitis,remnant stones,remnant gallbladder,etc.Results The biliary abnormality was found in thirty-eight of the 41 patients,including ductal dilatation in 20,intraductal stones in 16,cholangietis in 13,ductal stricture in 7,tumors in hepatic hila in 3.The biliary dilatation commonly presented within 3 months after operation while the biliary stricture and cholangeitis presented commonly 6 months after operation.Conclusion The biliary postoperative disoders is mainly caused by biliary dilatation,stricture and remnant stone,MRI is the sensitive and effective method for diagnosis of biliary abnormalities.

This study aims to explore the inferior adhesion of the renal fascia (RF), and the inferior connectivity of the perirenal spaces (PS) with multidetector computed tomography (MDCT), and to investigate the diagnostic value of CT for showing this anatomy. From May to July 2012, eighty-two patients with acute pancreatitis presented in our hospital were enrolled into this study and underwent contrast-enhanced CT scans. All the image data were used to perform three dimensional reconstruction to show the inferior attachment of RF and the inferior connectivity of PS. The fusion of anterior renal fascia (ARF) and posterior renal fascia (PRF) next to the plane of iliac fossa were found on the left in 71.95% (59/82) cases, and on the right in 75.61% (62/82). In these cases, bilateral perirenal spaces, and anterior and posterior pararenal spaces were not found to be connected with each other. No fusion of ARF and PRF below the level of bilateral kidneys occurred on the left side in 28.05% (23/82) cases and on the right side in 24.39% (20/82). In these patients, the PS extended to the extraperitoneal space of the pelvic cavity and further to the inguinal region, and bilateral anterior and posterior pararenal spaces were not found to be connected with each other. Three-dimensional reconstruction on contrast-enhanced MDCT could be a valuable procedure for depicting inferior attachment of RF, and the inferior connectivity of PS.
Abdominal Cavity ; anatomy & histology ; Adult ; Contrast Media ; Fascia ; anatomy & histology ; Humans ; Image Processing, Computer-Assisted ; Kidney ; anatomy & histology ; Multidetector Computed Tomography ; Pancreatitis ; pathology ; Pelvis ; anatomy & histology ; Tomography, X-Ray Computed

T cell immunoglobulin and mucin domain 3 (Tim-3) is well known to negatively regulate T cells responses, but its role in burn-induced T cells immune suppression remains unclear. In the present study, in order to identify the relationship between Tim-3 expression and post-burn T cells immune suppression, C57BL/6 mice were subjected to burn injury or sham injury, and the liver and spleen were harvested at the day 1 after operation. The expression level of Tim-3 on hepatic or splenic T cells and the functional properties of Tim-3(+) T cells were evaluated. It was found burn injury induced dramatically elevated Tim-3 expression on both hepatic and splenic CD4(+) and CD8(+) T cells in contrast with the post-burn depletion of T cells. Furthermore, Tim-3 expression was correlated with the suppressive phenotype of T cells following burn injury, including increased expression of anti-inflammatory cytokine IL-10, decreased expression of pro-inflammatory cytokines IFN-γ and TNF-α, reduced T cell proliferation and elevated co-expression of Tim-3 and PD-1. Moreover, Tim-3(+) T cells subsets were more prone to spontaneous apoptosis than Tim-3(-) T cells subsets. Our findings reinforce the idea that the up-regulated expression of Tim-3 on T cells after burn injury plays an important role in the development and maintenance of burn-induced T cell immune suppression.

Objective To apply the Chinese version of Care Transition Measure (C-CTM) in patients with chronic diseases to assess the quality of transitional care and its influencing elements in order to provide reference for improving the quality of transitional care. Methods A total of 210 patients with chronic diseases were telephoned 2 to 4 weeks after discharge using C- CTM. Results The C- CTM score of the 210 study participants was 52.37±15.45. The general self- care preparation scored the highest which was 65.48±15.07, written plan was the lowest with a median score of 16.67. Multiple regression analysis showed that education level, hospital class and Activity of Daily Living (ADL) scores upon admission were significantly positively associated with the C- CTM scores. Conclusions The overall quality of transitional care was poor, especially in written plan. Quality of transitional care was poorer in patients with lower education level, being admitted to lower class hospitals and with lower ADL scores upon admission.

Objective To define the factors that influence the safety of hepatectomy for hepatocellular carcinoma (HCC) associated with cirrhosis. Methods Based on the patients treated before and after February 1997,229 cases of HCC associated with cirrhosis were divided into two groups, Group A and Group B, respectively. The patients′ general condition, operative procedure, morbidity and mortality rates were compared between the two groups. The factors that influenced surgical morbidity were analysed. Results In group B, patients′ average age was higher (P

T cell immunoglobulin and mucin domain 3 (Tim-3) is well known to negatively regulate T cells responses,but its role in burn-induced T cells immune suppression remains unclear.In the present study,in order to identify the relationship between Tim-3 expression and post-bum T cells immune suppression,C57BL/6 mice were subjected to bum injury or sham injury,and the liver and spleen were harvested at the day 1 after operation.The expression level of Tim-3 on hepatic or splenic T cells and the functional properties of Tim-3+ T cells were evaluated.It was found burn injury induced dramatically elevated Tim-3 expression on both hepatic and splenic CD4+ and CD8+ T cells in contrast with the post-burn depletion of T cells.Furthermore,Tim-3 expression was correlated with the suppressive phenotype of T cells following burn injury,including increased expression of anti-inflammatory cytokine IL-10,decreased expression of pro-inflammatory cytokines IFN-γ and TNF-α,reduced T cell proliferation and elevated co-expression of Tim-3 and PD-1.Moreover,Tim-3+ T cells subsets were more prone to spontaneous apoptosis than Tim-3 T cells subsets.Our findings reinforce the idea that the up-regulated expression of Tim-3 on T cells after bum injury plays an important role in the development and maintenance of burn-induced T cell immune suppression.

Basic knowledge of forensic science is theoretical and abstract,therefore,confir-matory experiment teaching is often adopted in the experiment teaching. International education has become an important topic in medical colleges and universities. Forensic medicine is a compulsory subject for medical international students. This article discussed the exploration and practice in teach-ing forensic medicine for international students at Wenzhou Medical University,which included faculty constructing and training,encouraging whole English teaching by young teachers,applying heuristic interactive teaching and case teaching,establishing strict attendance and appraisal system and con-ducting comprehensive evaluation on medical teaching quality and teaching management.