Objective To put forward reasonable and feasible recommendations aiming at enhancing the application safety of afterloading unit, through studying the human reliability in the emergency response against the source blockage of afterloading unit.Methods Based on the human cognition reliability model, ten operation errors during the emergency response against the source blockage of afterloading unit were analyzed and permissible time widow of emergency response operation were determined.The human error probability was calculated with the execution time of emergency response operation obtained through simulation, observation and recording.Results The operation action, relevant permissible time window and execution time were obtained with the corresponding human error probabilities in the range 0.04 - 0.27.Conclusions The human error model in emergency response against the source blockage of afterloading unit based on HCRmodel is feasible, and provides important reference basis to reduce the occurrence of potential exposure and mitigate the consequence of potential exposure.

Objective To evaluate the efficacy and safety of dezocine versus sufentanil for postoperative patient-controlled epidural analgesia (PCEA).Methods PubMed,EMBASE,Cochrane Library,ISI Web of knowledge,Chinese Biomedical Database,Chinese Science-Technology Journal Database,China Journal Full-text Database and Wanfang Database were searched for randomized controlled trials involving the efficacy and safety of dezocine and sufentanil for PCEA from the date of database establishment up to April 2014.Randomized controlled trials met the inclusion criteria were included,and the data were extracted.The quality of the trials was evaluated according to Cochrane Handbook 5.1.0 criteria.Meta-analysis was conducted using RevMan 5.1 software.Results Seven studies involving 760 patients were included in this meta-analysis.The results of meta-analyses showed that there was no significant difference between dezocine group and sufentanil group in VAS scores at 4,8,12,16,24 and 48 h after surgery and in Ramsay sedation scores at 4,12,24 and 48 h after surgery,and the incidence of adverse reactions (postoperative nausea and vomiting,pruritus,urinary retention and somnolence) was significantly lower in dezocine group than in sufentanil group,and there was no significant difference in the incidence of respiratory depression and dizziness between dezocine group and sufentanil group.Conclusion Dezocine provides better efficacy and safety for postoperative PCEA than sufentanil.

Objective A comparability analysis was performed between the various parameters of the self-developed dry-type blood cell analyzer with the reference instrument (Sysmex XT-1800i).Methods In line with the evaluation program of blood cells issued by ICSH,the detection results,six parameters as HCT,Hb,GRAN (granulocytes),LM (lymphatic and monocytes),WBC and PLT,were compared between the two instruments.Some indexes of the subject instrument such as precision,comparability,outlier points,bias,etc.were analyzed and compared so as to calculate the equation of linear regression and the expected bias intervals.Results The intra and inter CV of the subject instrument about six parameters were respectively less than 5％ and 6％,so it showed that the instrument had good precision.Correlation analysis showed that the classification results of HCT,Hb,GRAN and WBC had a good correlation (r =0.991,0.972,0.986,0.975,P ＜0.01),while that of LM and PLT were slightly lower (r =0.952,0.942,P ＜0.01) ; As to the medical decision level,HCT values were 14％ and 70％,WBC 0.5 × 109/L and 3 ×109/L,and PLT 10 × 109/L,50 × 109/L and 100 × 109/L,and the acceptable bias of these values all fell in the confidence intervals; the values of the rest items were slightly higher than the high value of the confidence interval of expected bias.Conclusions The subject instrument produces the same results in the test of its parameters as the reference instrument Sysmex XT-1800i and therefore the two instruments are comparable.The subject instrument is particularly suitable for field rapid detection.

Objective To identify the steps with potentially higher risk through the analysis of human factors in clinical PET application so as to provide the efficient measures to reduce the risk of potential exposures.Methods The basic data were obtained through field investigation, questionnaire,failure mode, risk identification, FMECA and expert's evaluation, with statistical analysis made.Comparison was made of the relative risk values of automatic encapsulation equipment and manual encapsulation ones.Results The 10 steps with potentially higher risks were identified through analyzing human factors of clinical PET application, of which 8 occurred in the phase of chemical synthesis.The measures to control risk were addressed for the steps with higher risk.The results show that the relative risk value of the clinical process with automatic encapsulation equipment was 2.28 ± 0.99 and the one with manual encapsulation equipment was 3.20 ± 2.01 ( t = 2.56, P ＜ 0.05 ), with the latter being 76% of the former.Conclusions Failure mode and FMECA are effective in risk evaluation of clinical PET application, which can provide important basis for risk control.

Objective To study the effect of allodecedllular sheath extracellular matrix(ASECM) for repairing of the hernia. Methods 12 dogs were randomly divided into two groups:(1)ASECM repairing group (ASECM group), 6 dogs; (2) artificial materia (AM) repairing group (Control group), 6 dogs. Abdominal wall defect of 3cm?5cm area was made on both of right and left abdomen in ASECM group and control group. The defect of left abdomen was not repaired as a self-control. The defect of right abdoment was repaired by ASECM in ASECM group , and by AM in control group . Microscopically, imunohistochemical study and electroscopy were performed 2,8,16 weeks after operation in both ASECM group and control geoup. Results A hernia could be seen on the defect of left abdominal wall in both groups 2 days after operation, but no hernia was found on the defect of right abdominal wall. In ASECM group , microscopy showed that the number of fibroblast cells (FBC) growing in the ASECM increased graduately 2～8 weeks after operation, but decreased 16 weeks after operation, and no inflammatory cells infiltration was seen at any time;electroscopically, the ASECM was filled with clear ranked thin collegen 16 weeks after operation. Contrarily, in control group, microscopy showed that the amount of covering the superficialness of AM increased graduately 2～8 weeks after operation, but not many FCs could be seen inside the AM, and inflammatory cells infiltration was found at every time postoperativly. Electroscopically, FCs grew to cover the superficialness as reaction of host to the foreign body ,and the AM had not merged with host tissues. Immuohistochemical study showed that there were typy I and III collegen presented in the repairing materias. Conclusions ASECM can provide a fram for the host FCs growth, So the ASECM can be mixed together with host tissues to provide a good intensive potency against hernia recurrence, and ASECM might be an ideal tissue-engineering materia for repairing hernia.

Objective:To evaluate the role of spinal Leucine-rich Repeat Kinase 2 (LRRK2) in neuropathic pain in rats.Methods:Fifty SPF healthy male Sprague-Dawley rats, aged 6-7 weeks, weighing 210-245 g, were divided into 5 groups ( n=10 each) using a random number table method: control group (C group), neuropathic pain group (NP group), low dose GNE-7915 group (low-dose GNE-7915 group), medium-dose GNE-7915 group (medium-dose GNE-7915 group), and high-dose GNE-7915 group (high-dose GNE-7915 group). Neuropathic pain was induced by the spared nerve injury in anesthetized rats. At 7 days after developing the model, LRRK2 inhibitor GNE-7915 12.5, 25.0 and 50.0 mg/kg were intraperitoneally injected in low-, medium- and high-dose GNE-7915 groups, respectively. The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured before developing the model, at 7 days after developing the model, and at 4 h after injecting the inhibitor. After measurement of the pain threshold, the rats were sacrificed and the spinal cord tissues were taken for determination of the positive expression of ionized calcium-binding adapter molecule 1(Iba-1) (by immunofluorescence staining), contents of interleukin-1β (IL-1β), monocyte chemotactic protein-1 (MCP-1) and IL-18 (by enzyme-linked immunosorbent assay), positive expression of phosphorylated LRRK2 (p-LRRK2) (by immunofluorescence staining), and expression of LRRK2, IL-1β, MCP-1 and IL-18 (by immunoblotting). The ratio of p-LRRK2/LRRK2 was calculated. Results:Compared with C group, the MWT was significantly decreased, the TWL was shortened, the proportion of Iba-1 and p-LRRK2 positive cells in spinal cord tissues, contents of IL-1β, MCP-1 and IL-18, and p-LRRK2/LRRK2 ratio were increased, and the expression of IL-1β, MCP-1 and IL-18 proteins was up-regulated in NP group ( P<0.05). Compared with NP group, the MWT was significantly increased, the TWL was prolonged, the proportion of Iba-1 and p-LRRK2 positive cells in spinal cord tissues, contents of IL-1β, MCP-1 and IL-18, and p-LRRK2/LRRK2 ratio were decreased, and the expression of IL-1β, MCP-1 and IL-18 proteins was down-regulated in low-, medium- and high-dose GNE-7915 groups ( P<0.05). Conclusions:LRRK2 in the spinal cord may be involved in the pathophysiological mechanism of neuropathic pain by activating microglia and inducing inflammatory responses in rats.

Objective To study the effect of leucine rich repeat kinase 2(LRRK2)on pain sensitivity in neuro-pathic pain(NP)rats and explore its possible mechanism.Methods 48 SD rats were randomly divided into four groups:sham surgery(Sham),model,LRRK2 inhibitor(MLi-2),and LRRK2 inhibitor+p3 8 mitogen activated pro-tein kinase(MAPK)agonist(MLi-2+Anisomycin),with 12 rats in each group.The NP rat model was induced by chronic constriction injury(CCI)of the sciatic nerve.Intrathecal injection of MLi-2(1 mg/kg,10 μl)or Anisomy-cin(20 μmol/L,10 μl)was started from the 8th day after surgery,once a day for 7 consecutive days.Pain sensi-tivity tests were conducted before surgery(day 0)and on postoperative days 7 and 14,respectively.The changes in mechanical withdrawal threshold(MWT)and paw withdraw thermal latency(PWTL)were analyzed in each group of rats.ELISA was used to detect the levels of interleukin-1 β(IL-1β),IL-6 and tumor necrosis factor-α(TNF-α)in the dorsal horn of the rat spinal cord.Nissl staining was used to observe the pathological changes of neurons in rat spinal cord tissue.Immunofluorescence staining was used to observe the expression levels of ionized calcium-binding adapter molecule-1(Iba-1),a marker of microglia in the spinal cord of rats.Western blot was used to detect the protein expression levels of LRRK2,p-p38 mitogen activated protein kinase(MAPK),p38 MAPK,and Iba-1 in the dorsal horn of the rat spinal cord.Results Compared with the sham group,the model group showed a significant decrease in MWT and PWTL in the right hind limb of rats(P＜0.01).The levels of IL-1,IL-6,and TNF in the spi-nal dorsal horn tissue,as well as the expression levels of LRRK2,Iba-1 proteins and p-p38 MAPK/p38 MAPK pro-tein ratio significantly increased(P＜0.01).The proportion of Iba-1 positive cells in the spinal cord tissue signifi-cantly increased(P＜0.01),while Nissl bodies were significantly reduced(P＜0.01).Compared with the model group,the MLi-2 group showed a significant increase in MWT and PWTL in the right hind limb of rats(P＜0.01),a significant increase in Nissl bodies(P＜0.01),a significant decrease in the proportion of Iba-1 positive cells in the spinal cord tissue(P＜0.01),and a significant decrease in the levels of IL-1,IL-6,and TNF and the expression levels of LRRK2,Iba-1 proteins and p-p38 MAPK/p38 MAPK protein ratio(P＜0.01).However,Anisomychin in-tervention could activate the p38 MAPK signaling pathway and partially reverse the beneficial effects of MLi-2 on pain sensitivity and neuroinflammation in rats with neuropathic pain.Conclusion Inhibiting the expression of LRRK2 can alleviate pain sensitivity in NP rats induced by microglia activation mediated neuroinflammation,and its mechanism of action may be related to regulating the p38 MAPK signaling pathway.

Objective To investigate the role and mechanism of silent information regulator 1(SIRT1)-NOD-like receptor protein 3(NLRP3)axis in the effect of remifentanil against ischemia-reperfusion injury(IRI)in rat livers.SD rats were randomly divided into sham operation group(sham group),IRI group,IRI+remifentanil pretreatment group(IRI+RPC group),IRI+SIRT1 inhibitor EX-527 group(IRI+EX-527 group)and IRI+RPC+EX-527 group,with 8 rats in each group.The levels of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),lactate dehydrogenase(LDH),interleukin(IL)-1β and IL-18 of rats in each group were detected.The liver tissue pathology was observed.The apoptosis rate of hepatocytes in rats was detected.The expressions of SIRT1,NLRP3,cleaved cysteinyl aspartate specific proteinase-1(Cleaved Caspase-1)and Gasdermin D(GSDMD)proteins in rat liver tissue were detected.Results Compared with the sham group,the liver tissue pathological score and hepatocyte apoptosis rate of rats in the IRI group were increased,the serum ALT,AST,LDH,IL-1β,and IL-18 levels were increased,the relative expression of SIRT1 protein in liver tissue was decreased,and the relative expression of NLRP3,Cleaved Caspase-1,and GSDMD proteins were increased(all P<0.05).Compared with the IRI group,the liver tissue pathological score and hepatocyte apoptosis rate of rats in the IRI+RPC group were decreased,the serum ALT,AST,LDH,IL-1β,and IL-18 levels were decreased,the relative expression of SIRT1 protein in liver tissue was increased,and the relative expression of NLRP3,Cleaved Caspase-1,and GSDMD proteins were decreased;the liver tissue pathological score and hepatocyte apoptosis rate of rats in the IRI+EX-527 group were increased,the ALT,AST,LDH,IL-1β,and IL-18 levels were increased,the relative expression of SIRT1 protein in liver tissue was decreased,and the relative expression of NLRP3,Cleaved Caspase-1,and GSDMD proteins were increased(all P<0.05).Compared with the IRI+RPC group,the liver tissue pathological score and hepatocyte apoptosis rate in the IRI+RPC+EX-527 group were increased,the levels of ALT,AST,LDH,IL-1β,and IL-18 were increased,the relative expression of SIRT1 protein in liver tissue was decreased,and the relative expression of NLRP3,Cleaved Caspase-1,and GSDMD proteins were increased(all P<0.05).Conclusions SIRT1 may participate in the regulation of remifentanil against rat liver IRI by inhibiting NLRP3 mediated cell pyroptosis.

Objective:To study the pupillary centroid shift of myopia and characteristics of pupil diameter change from scotopic to photopic condition.Methods:A case series study was carried out, 140 eyes of 70 myopia patients from September to November 2016 in Tianjin Eye Hospital were enrolled.The pupillary centroid shift and pupil diameter parameters were measured by visual quality analyzer from scotopic (0.017 lx) to photopic (10.400 lx) condition.This study followed the Declaration of Helsinki.Results:Under the scotopic and photopic conditions, the pupil diameter was positively correlated between the bilateral eyes (scotopic: rs=0.85, P<0.001; photopic: r=0.85, P<0.001), and the pupil diameter variation from scotopic to photopic condition was positively correlated between the bilateral eyes ( r=0.75, P<0.001). The pupil diameter in scotopic and photopic conditions, and the change of pupil diameter in the right eyes were significantly higher than those in the left eyes (all at P<0.05). The pupillary centroid shift was within 0.2 mm in the left eyes of 94.2% (66/70) subjects and in the right eyes of 97.1%(68/70) subjects.The pupillary centroid shift of all subjects was within 0.3 mm.From scotopic to photopic condition, the pupil centroid was mainly shift to the nasal superior direction.There was no significant correlation between pupil diameter and age or gender.There was no significant correlation between pupillary centroid shift and age, diopter or pupil diameter. Conclusions:The binocular pupillary centroid shift are symmetrical from scotopic to photopic condition in myopic eyes, and the pupil centroid mainly shift to nasal superior direction.

Humans ; East Asian People ; Psoriasis/drug therapy* ; Antibodies, Monoclonal, Humanized/therapeutic use* ; Treatment Outcome ; Severity of Illness Index