Quality of care and safety are the lifeline of hospital performance and hospital management.With reference to the KTQ hospital quality certification system of Germany,Tongji Hospital built platforms to supervise outpatient,emergency,inpatient,surgical operation,nursing, hospital-acquired infection,and pharmacy management.By the connection and reaction of both online and offline systems,Tongji Hospital has built a systematic,informationized and precise medical quality and safety system for large public hospitals,safeguarding quality of care and safety of patients.

BACKGROUND: Thoracolumbar burst fracture Dennis type B does not have significant damage in the intervertebral discs of the inferior vertebral body. To reduce fusion segment and remain normal intercalated disc, single discectomy (damaged vertebral body and supervisor vertebral body) is proposed, but because of the damage to the vertebral body, implanted screw is easy to loose following excising partial vertebral body, even cannot be fixed. However, it is still unknown whether implanted screw in the inferior vertebral body of the damaged vertebral body was stabilized using two segment discectomy with fixation.OBJECTIVE: To analyze the feasibility of single segmental spinal interbody fusion with bisegment fixation for thoracolumbar burst fracture type B.DESIGN, TIME AND SETTING: The randomized controlled in vitro study was conducted at the Laboratory of Biomechanics, Southern Medical University from June 2007 to June 2008.MATERIALS: A total of 20 fresh freezing 7-9 months pig samples (T_(13)?L_3 segment) were used, comprising 10 integral samples and 10 L_1 type B thoracolumbar burst fracture samples prepared by pre-injury and weight dropping technique.METHODS: Pig fresh thoracolumbar specimens from T_(13)?L_3 were collected to create models of type B thoracolumbar burst fracture. There were 4 groups in this study. Ten of them were selected as intact group (n=10) (fresh pig T_(13)?L_3 segment). T_1 vertebral endplate pre-injury and weight dropping technique and incremental trauma approach were used. Denis' type B burst fracture was produced, and ten of them were selected as unstable group (n=10). Firstly, unstable group was decompressed by discectomy and semivertebraectomy in upper half of the vertebral body, single level was fused with iliac and U-FRONT anterior thoracolumbar system were placed between T_(14) and L_2, as single discectomy with fixation group (n=10). Then lower disc of injury vertebra discectomy and vertebraectomy, fused with iliac U-FRONT anterior thoracolumbar system were placed between T_(14) and L_2, as two segment discectomy with fixation group (n=10). The bone graft was longer 1 mm than the bone graft region.MAIN OUTCOME MEASURES: The flexion, extension, right/left lateral bending, and right/left axial rotation range of motion (ROM) of T_(14)?L_2 were measured in each group on the spinal three-motional test machine at 10 N穖.RESULTS: The flexion, extension, right/left lateral bending, and right/left axial rotation were not stable in the unstable group.ROM was significantly increased in the unstable group compared with the intact group (P< 0.01). The primary stability was significantly elevated in the single discectomy with fixation and two segment discectomy with fixation groups. The flexion, extension, right/left lateral bending, and right/left axial rotation ROM were significantly reduced in the single discectomy with fixation and two segment discectomy with fixation groups compared with the unstable group (P < 0.05). The flexion, extension, right/left lateral bending ROM was significantly decreased in the two groups compared with the intact group, but axial rotation ROM was significantly increased (P< 0.05). Axial rotation ROM was smaller in the single discectomy with fixation group compared with the two segment discectomy with fixation group (P < 0.05).CONCLUSION: Single segmental spinal interbody fusion with bisegment fixation for thoracolumbar burst fracture type B had a good immediate stability in flexion, extension, lateral bending motion. Compared with traditional partial corpectomy L_1 between the caudal and cranial endplate of the adjacent vertebrae with bisegmental fixation, it had a better immediate stability in axial rotation.

Object To demonstrate the naked truth of four therapeutic features of TCM (cold, hot, warm and cool) from biophysical and biochemical point of view. Methods Growth thermogenesis curves of Escherichia coli were determined under different conditions by microcalorimetry to give biothermodynamic parameters, such as multiplication constant (k), median inhibitory concentration (IC 50 ), and enthalpy (?H). Differences between folia ginseng and flos ginseng were comprehensively compared with reference to classical Chinese literatures on material medica. Results The bacteriostatic curve of both drugs were basically similar. With increasing concentration of decoctions of both drugs, the lag phase was delayed and the peaks shifted to the right. While the difference of ?H was stable, which decreases with the increasing concentration of Folium ginseng, but increases with increasing concentration of Flos ginseng. Conclusion Microcalorimetry is not only a new effective method to describe the therapeutic features of TCM, but also could be used as a tool for the screening of active TCM.

The cholinesterase(ChE)and lactate dehydrogenase(LDH)activities in blood smears of 37 patients were observed before and 20 minutes after electroacupuncture.Hegu and Zusanli were mainly chosen as the acupuncture points.Karnovsky method was used to demonstrate ChE,activity,and tetrazolium-formazan reaction for LDH activity. Before acupuncture,all formed elements of blood showed both ChE and LDH acti- vities.In red blood cells ChE and LDH activities were localized at the cell membrane, while in white blood cells they were found throughout the cytoplasm as colored granu- les.The granulocytes showed greater ChE and lesser LDH activities than the lymph- ocytes.The platelets also showed greater LDH and ChE activities,especially the former. On the whole,platelets and leucocytes,as compared with erythrocytes,showed greater activities for ChE and LDH. Under microscopic observation,according to the amount and color of granules,the degrees of GhE and LDH activities for each kind of blood formed elements before and after acupuncture were recorded as different markes,such as +、++、+++ and so on.The degrees of GhE or LDH activity in various formed elements of blood were compared by means of statistical tests.After acupuncture,both GhE and LDH activities of all blood formed elements were increased(p

70 patients including 60 cases under acupuncture anesthesia and 10 cases under drug anesthesia were observed. Before and 20 minutes after acupuncture the blood samples were taken from the patient ear lobes respectively, and in some patients taken once again 24 hrs after acupuncture. The electroacupuncture point Hegu or Zusanli was mainly adopted. As the method for detection of cell-mediated immunity(CMI) in vitro the improved microtechnique of whole blood for E-rosette (active and nonactive) and lymphocyte transformation tests was used. In performance of active rosetting the total leucocyte count and the differential lymphocyte count were done for calculation of absolute number of active rosette forming cells (RFC). The mean value of increase of active RFC was 12.7?1.43, the decrease was 6.8?1.77 after acupuncture. The increment of the absolute number of active RFC was 175?63.59. However no marked effect on the drug anesthesia group was found. In the lymphocyte transformation assay the increase was 12.7?1.49, the decrease was 7.0?2.19, and the enhancement effect still exhibited 24 hrs after acupuncture. In these tests an increase was mostly found in those with a lower or a usual CMI level; a decrease often found in those with a higher CMI level prior to acupuncture. The increase or decrease level in the results of three kinds of test (active, nonactive RFC and lymphocyte transformation) was similar, the increase range was 12～13%, the decrease range 6～7%. As the former compared with the latter, the promotion was prominent by all means.

OBJECTIVETo study the protective effect of panax notoginseng saponins (PNS) against apoptosis of the superficial cells of rat renal cortex following femoral fracture in rats.

METHODSNinety Wistar rats were randomized into 3 groups, namely the fracture group (n=36), fracture with PNS treatment group (n=36), and normal control group (n=18). At 1, 6, 12, 24, 36, and 48 h after femoral fracture, 6 rats from first two groups and 3 from the control group were sacrificed to observe renal pathologies with HE-staining. Immunohistochemistry and in situ hybridization were used to detect Bcl-2 and Bax expression, and TUNEL staining was employed to detect the distribution of apoptotic cells.

RESULTSIn the fracture group, the renal cortex showed telangiectasia and granular degeneration of proximal tubule, which were lessened in the PNS treatment group. Compared with the control group, the fracture group showed significantly increased Bcl-2 and Bcl-2 mRNA expressions in the renal cortex at 1-12 h (P<0.01) and increased Bax protein expression at 12-36 h (P<0.01) with increased Bax mRNA expression at 24-48 h (P<0.01). In PNS treatment group, Bcl-2 protein expression at 1 h and Bcl-2 mRNA expression at 12-48 h were significantly higher (P<0.01), but Bax protein and mRNA expressions at 24-48 h were significantly lower (P<0.01) than those in the fracture group.

CONCLUSIONFemoral fracture obviously affects Bcl-2 and Bax protein and mRNA expressions in the superficial cells of the renal cortex, PNS can suppress the cell apoptosis by down-regulating Bax expression and up-regulating Bcl-2 expression.

Animals ; Apoptosis ; drug effects ; Femoral Fractures ; pathology ; Kidney Cortex ; metabolism ; pathology ; Male ; Panax notoginseng ; chemistry ; Plants, Medicinal ; chemistry ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; RNA, Messenger ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Saponins ; isolation & purification ; pharmacology ; bcl-2-Associated X Protein ; genetics ; metabolism

Chronic ulcer of the lower extremities amounts for a grave and serious problem for public health. Western medicine focuses on controlling infection, improving blood circulation, surgical debridement, skin grafting, etc, but there are bottlenecks in the treatment. Traditional Chinese medicine (TCM) has a long history and a legacy of sound clinical efficacy in this area. TCM has developed a unique, effective external theory, and a large number of topical prescriptions and external technology. Through this research, a safe and effective treatment protocol of TCM for chronic ulcer of the lower extremities can be formed. To this end, during China's "Eleventh Five-Year" Plan, special research committees and projects on TCM external treatments and external technologies were established. This study on ulcer of the lower extremities constitutes one of the major research topics.

Morulaes and blastocysts obtained from Guanzhong dairy goats 6-7 days after mating were treated with whole embryo cultivaton, enzymatic digestion and immunosurgery separately. The goat embryonic stem cells (ESC) were isolated and cultured on a feeder layer of mitomycin-inactivated mouse embryo fibroblasts (MEF). The characteristics of goat ESCs were analyzed by immunohistochemisty, RT-PCR and inducing differentiation in vitro. The results indicated that the embryos were easier to attach the culture dish and form primary colonies with whole embryo method. There were colonies that maintained undifferentiated for 18 passages. The ESCs expressed the protein of Nanog, Oct4 and SSEA-3, whereas the protein of SSEA-4 was absent and the protein of SSEA-1 was weakly expressed. In addition, the genes of Nanog, Oct4, TERT and CD117 were expressed in goat ESCs. The cells also could differentiate to myocardial cells when induced in vitro by DMSO. These results suggest that the goat ESCs have characteristics of ESCs.
Animals ; Blastocyst ; cytology ; Cell Differentiation ; physiology ; Cell Separation ; methods ; Cells, Cultured ; Embryo Culture Techniques ; Embryo, Mammalian ; cytology ; Embryonic Stem Cells ; cytology ; metabolism ; Female ; Goats ; Male ; Mice ; Myocytes, Cardiac ; cytology ; Rabbits

To optimize program of bovine somatic nuclear transfer, we used two different enucleation procedures (by Spindle-view system & Hoechst 33342 staining), two different procedures to introduce donor nuclei (by ooplasm microinjection & electrofusion), and three different group electrofusion parameters (group 1: 1.9 kV/cm, 10 micros, two; group 2: 1.5 kV/cm, 25 micros, two; group 3: 0.6 kV/cm, 100 micros, one) to reconstruct bovine cloned embryos. The cleavation rates and blastocyst development rates of cloned embryos were used to assess the efficiency of different operational procedure. Finally, the best combination of operational procedure, that the spindle-viewer system was used for oocytes enucleating, and donor cell was electrofused into ooplasm by electrical pulse (1.9 kV/cm, 10 micros, two) to reconstruct bovine cloned embryos. Then the excellent blastocysts were transferred to fosters for producing cloned cattle 80 high-quality cloned blastocysts were transferred into 33 fosters, two cloned calves were produced. According to the results, the optimized program could be used to produce cloned cattle.
Animals ; Cattle ; Cell Nucleus ; physiology ; Cloning, Organism ; veterinary ; Embryo Transfer ; methods ; Embryo, Mammalian ; cytology ; physiology ; Female ; Microinjections ; Nuclear Transfer Techniques ; veterinary ; Oocytes ; cytology ; physiology