Objecive To explore modern management and optimization of hospital warehouse slotting with some class A tertiary hospital taken as an example.Methods EIQ_ABC classification method,multi-objective assignment model and genetic algorithm were used to analyze and simulate the data of 126 kinds of medical devices for 20 orders.Results The medical devices were divided into nine categories of Ⅰ A,Ⅰ B,Ⅰ C,Ⅱ] A,Ⅱ B,Ⅱ C,Ⅲ A,Ⅲ B and Ⅲ C.It's suggested that emphasized management and precision slotting storage were carried out for A categories of devices,dedicated storage for B categories and random storage for C categories.At the same time,the layout of the warehouse was optimized according to the importance of the goods so that the important goods were placed near the passageway.Slotting analog simulation diagram was obtained based on multi-objective assignment model of Ⅲ A category medical device.Conclusion Classified management and allocation as well as slotting optimization of medical devices contribute to improving hospital modern management in efficiency,cost and error rate.

AIM: To find new methods for heavy metals pollution in traditional Chinese medicine(TCM) with macroporous chelating resins. METHODS: We emulsificated crude extracts of TCM and adjusted its pH to 7 first and the pretreated crude extracts was treated by three kinds of macroporous resins(D401,D402 and D001) respectively,then we detected the concentrations of 5 heavy metals(Cu,Pb,Cd,Hg,As) and flavonoids in the crude extracts with or without treatment. RESULTS: The concentrations of all heavy metals decreased significantly after treatment of D401 and D402.The concentrations(mg/L) of Cu,Pb,Cd changed from 0.500,0.521,0.078 to 0.117 and 0.236,0.174 and 0.165,0.024 and 0.045,respectively,and Hg and As became beyond the detection limit after the treatment,but the use of D001 affected a bit quantities of 5 heavy metals.Moreover,the concentration of flavonoids kept almost the same after treatment of such 3 resins.On the condition of room temperature,we found that a fluent velocity of 30 m/s and pH of 7 would bring the superior treatment of D401 to excessive heavy metals in TCM. CONCLUSION: Macroporous chelating resins(D401 and D402) can be employed in the treatment of excessive heavy metals in crude extracts of TCM.

With the development of systems biology and high-throughput molecular technologies, systems toxicology has come into being. The up-date understanding of systems toxicology is the study of the perturbation of biological systems by using chemicals and stressors, monitoring changes in molecular expression (transcript, protein and metabolite profiling), conventional toxicological parameters and iteratively integrating response data to describe the functioning organism. The background, research framework, supporting tools and the main applications of systems toxicology were discussed in detail in the present paper. Although in its infancy, systems toxicology will play an important role in advancing the study of environmental stress and heath impact definitely.

This study was aimed to take an expert survey on the application of traditional Chinese medicine (TCM) in different clinical classifications of coronary heart disease (CHD) in order to master its medication characteristics and principles . Delphi method was applied in different clinical classifications of CHD , which contain angina pectoris, acute myocardial infarction, heart failure, arrhythmia, after percutaneous coronary inter-vention ( PCI ) and after coronary artery bypass graft ( CABG ) . Two rounds of nationwide expert survey were giv-en on the commonly-used TCM decoction , oral administration of TCM patent drugs and TCM intravenous preparations in CHD treatment . The results showed that TCM medications in the treatment of angina pectoris contain Xuefu Zhuyu decoction, Gualou Xiebai Banxia decoction, Tongxinluo capsules, Compound Danshen dripping pills, Shexiang Baoxin pill, Danshen injection, Danhong injection, and etc. And commonly used TCM medications for the treatment of acute myocardial infarction include Xue fu Zhuyu decoction , Gualou Xiebai Banxia decoction, Compound Danshen dripping pills, Shexiang Baoxin pill, Suxiao Jiuxin pills, Shengmai injec-tion , She nmai injection and so on . Heart failure of CHD was treated by Zhenwu decoction , Qili Qiangxin cap-sule, Qishen Yiqi dripping pills, Shenfu injection, Shengmai injection, Shenmai injection and so on. TCM treatments of arrhythmia of CHD usually include Zhigancao decoction , Tianwang Buxin boluses , Wenxin gran-ules, Shensong Yangxin capsule, Shengmai injection, Shenmai injection and so on. The commonly used TCM medications after PCI contain Xuefu Zhuyu decoction, Tongxinluo capsules, Compound Danshen dripping pills, Shengmai injection and Danshen injection and so on. Commonly used TCM medications after CABG include Xuefu Zhuyu decoction, Buyang Huanwu decoction, Tongxinluo capsules, Shexiang Baoxin pill, Compound Dan-shen dripping pills, Shengmai injection and Danhong injection and so on. It was concluded that different clini-cal classifications of CHD had characteristics and commonness in the application of TCM . Findings based on expert consensus through the survey provide certain reference values in the clinical syndrome differentiation of CHD .

Objective To evaluate the clinical value of laparoscopy in the diagnosis and treatment of intestinal duplication for children. Methods From June 2002 to May 2007, 15 children (aged 27 days to 10 years) with intestinal duplication were treated by laparoscopy in our hospital. The lesions were explored by laparoscopy, and then pulled out through the umbilical hole or the trocar hole at the right lower abdomen. The anastomosis was performed outside the abdominal cavity. Results The operation was successfully accomplished in all the patients. No serious postoperative complications occurred. Among the cases, end-to-end anastomosis was performed on 12 patients, resection of the duplicated intestine on 2, and demucosation on 1. Simultaneously, appendectomy was performed on 2 cases, and ring suturing for inguinal hernia on 1. The patients were followed up for 3-18 months (mean, 12 months), during which no patients had symptoms of intestinal adhesion (abdominal distension, vomiting), hemorrhage, or incisional hernia. Conclusions Laparoscopy is effective and reliable with a high diagnostic rate and low complication rate in the diagnosis and treatment of intestinal duplication for children.

According to the characteristics of general surgery class teaching,methods and experiences of the application of associative approach to general surgery class teaching were analyzed,such as word,picture,contrast,comprehensive,analogical and association,which is advantageous to the improvement of class teaching methods,effects and students' study interests and ideation.

Objective To study the impacts of different applicators on dose distribution in 192 Ir brachytherapy. Methods The inner tubes of two cylinder applicators from Nucletron,#101?001 and#084?350, were made of plastic and stainless steel, respectively. The cylinder parts of them were made of plastic, and had four different radiuses:1?00 cm, 1?25 cm, 1?50 cm, and 1?75 cm. EGSnrc program was used to simulate dose distribution when applicators were present in a phantom, and the results calculated by the treatment planning system were compared with the results of EGSnrc. The impacts of applicators on dose distribution were analyzed with different materials, thickness, and numbers of resident source. Results There was no significant relationship between dose deviation and the radius for the two applicators. When an applicator was present, the actual dose delivered to a patient was smaller than the planned dose. The dose deviation of the applicator#101?001 was no more than 1%, while the dose deviation of the applicator#084?350 was close to 3%. The dose deviation remained the same when the number of resident source changed. Conclusions The plastic applicator, if possible, is the best choice for brachytherapy right now. In a long term, in order to promote the accuracy of brachytherapy, current dosimetry algorithm should be improved, and the impacts of the applicator made of metal, such as stainless steel, on dose distribution should be taken into account.

Objective To investigate the feasibility of the virtual source model in Monte Carlo dose calculation for clinical radiotherapy.Methods The Monte Carlo simulation was used to obtain the phase space files which recorded the physical properties of the particles emitted by a medical linear accelerator, and the information on the type, energy spectrum, and distribution of particles were extracted from these files and analyzed to establish the semi-empirical model of virtual two-photon source.The GMC dose calculation engine was used to obtain the 3 cm×3 cm, 5 cm×5 cm, 10 cm×10 cm, 20 cm×20 cm, and 30 cm×30 cm fields of radiotherapy and the results of Monte Carlo simulation of dose distribution in three-dimensional water phantom in 2 intensity-modulated radiotherapy ( IMRT) plans.These results were compared with the results of water phantom measurement or the results of Elekta Monaco planning system to verify the accuracy of Monte Carlo dose calculation based on a virtual source.Results As for the percentage depth-dose distribution curves of the central axis of the water phantom and the off-axis dose curves at different depths in the five fields for radiotherapy, the difference between the results of Monte Carlo simulation and the results of measurement was within 1%.As for the two IMRT plans, the three-dimensional passing rates of Monaco calculation results and Monte Carlo simulation results were 98.9%and 99.4%, respectively, for 3%/3 mm, and 95.1%and 95.4%, respectively, for 2%/2 mm.Conclusions Monte Carlo simulation based on the virtual source model can obtain accurate results of radiotherapy dose calculation.

Objective To compare the differences and characteristics of the dose distribution of the two optimization methods in the three dimensional brachytherapy,and provide the basis for clinieal treatment.Methods Excel 2007 was used to generate random number.And a total of 21 patients of cervical cancer were selected from those who have completed the treatment.Inverse simulated annealing optimization (IPSA) plans were designed for graphical optimization (GO) plans.The dose volume histogram (DVH) parameters of the targets (V100％,V150％) and the organs (D1 cm3,D2cm3) of the two methods were analyzed.Results The targets dose of both plans could meet the prescription requirements.There was no statistically significant difference in the dose parameters of all targets (P ＞ 0.05).The closes of D1 cm3 and D2cm3 in the bladder of IPSA plan were significantly lower than that of the GO plan (t =3.596,3.490,P ＜ 0.05).There was no statistically significant difference in the dose parameters of rectum (P ＞ 0.05).Conclusions For cervix brachytherapy,the GO and IPSA have no effect on targets dose,but IPSA optimization can reduce the maximum dose of bladder.

Objective To analyze the pre-transplant sera of renal graft recipients for soluble CD30 level and study the correlation between sCD30 level and acute rejection (AR),lung infection or renal graft loss.To investigate the feasibility of sCD30 level for pre-transplant risk evaluation in renal transplant recipients.Methods 586 renal graft recipients were enrolled into this study,who had complete 5-year follow-up data and sufficient pre-transplant sera for analysis.Pre-transplant sera were collected for detection of sCD30 level by ELISA and patients were divided into three groups according to sCD30 level:group L (sCD30＜120 U/ml),group I (sCD30 120-240U/ml) and group H (sCD30 ＞240 U/ml).Incidence of AR,lung infection,graft loss and postoperative 5-year patients and renal allograft survival rate were compared among three groups.Correlation analysis was also performed between pre-operative sCD30 level and postoperative dialysis time,AR,or lung infection.Results The average pre-transplantation sCD30 level was significantly higher than that of healthy individuals (P＜0.01 ).During the 5-year follow-up period,the incidence of AR in groups L,I and H was 17.4％ (45/259),29.2％ (77/264) and 42.9％ (27/63) respectively,and the lung infection rate was 20.8％,8.3％ and 15.9％ respectively.There was significant differences in AR incidence and lung infection rate among these three groups (P＜0.01).The pre-transplantation sCD30 level in patients with AR was (180.0± 89.1) U/ml,which was significantly higher than in those without AR (135.3 ± 72.7 U/ml,P＜0.01).The pre-transplantation sCD30 level in patients with lung infection was (123.2±75.5) U/ml,which was significantly lower than in those without lung infection (150.7 ± 79.6 U/mL,P＜0.01).The pre-transplantation sCD30 level had a positive relationship with AR (r =0.242,P＜0.01),but a negative correlation with lung infection (r=- 0.147,P＜0.01).In group H, five-year cumulative survival rate of recipients and renal grafts was 79.4％ and 69.8％ respectively,which was significantly lower than in group L (90.3％ and 87.3％),and group I (91.3％ and 87.6％) (P＜0.05,P＜0.01),but there was no significant difference between group L and group I (P＜0.01).Conclusion Pretransplant sCD30 level in renal transplant recipients is remarkably correlated with postoperative AR and lung infection,which can be considered as an independent predictor for postoperative AR,lung infection and the risk of graft function loss.