Objective To investigate the medical effect of the ethanol extract of Acorus gramineus Sol.on arthritis of mice induced by collagen-Ⅱ,and explore the potential pharmacological mechanisms.Methods Arthritis mouse model was established by injection of admixture containing type Ⅱ collagen and Freund's complete adjuvant (FCA) in male BALB/c mice.Mice were divided into five groups:the normal control group (0.9% of sodium chloride solution),the model control group (0.9% of sodium chloride solution),tripterygium group (15 μg·kg-1 of tripterygium tablets), the high-dose of extract of Acorus gramineus Sol.group (60 mg·kg-1 extract of Acorus gramineus Sol.) and the low-dose of extract of Acorus gramineus Sol.group (15 mg·kg-1 extract of Acorus gramineus Sol.).Each group was administered once a day,lasting 21 days.During the experiment,ankles of all mice were measured at predetermined time.At the end of the experiment,blood of the mice was exsanguinated and centrifuged to get serum for measuring the levels of IL-1β,RF and TNF-α.Spleens of mice were dissected and weighed to calculate the spleen index.All arthritis ankles were dissected to make tissue section,and observed under microscope.Results Compared with the model control group,the perimeter of ankle joints of the high-dose of extract of Acorus gramineus Sol.group significantly changed 6 days after administration (P<0.05);That of the low-dose of extract of Acorus gramineus Sol.group significantly changed 12 days after administration (P<0.05);That of tripterygium group significantly changed 9 days after administration (P<0.05).As compared with the normal control group, the spleen index of the model control group was significantly different (P<0.01).As compared with the model control group,the spleen index of tripterygium group,high-dose and low-dose of extract of Acorus gramineus Sol.groups were significantly different (P<0.05).As compared with the normal control group,levels of IL-1β,RF and TNF-α of the model control group were significantly different (all P<0.01).As compared with the model control group,levels of IL-1β,RF and TNF-α of tripterygium group,high-dose and low-dose of extract of Acorus gramineus Sol.groups were significantly decreased.Conclusion Ethanol extracts of Acorus gramineus Sol.have significant therapeutic effect on arthritis mice.The anti-arthritic mechanism is associated with its ability to regulate levels of IL-1β,RF and TNF-α.

OBJECTIVETo dicuss the clinical efficacy of Timolol Maleate Eye Drops in the treatment of superficial infantile hemangiomas. Methods From April 2012 to May 2014, 210 patients with superficial infantile hemangiomas were included. According to the parents' choice, a total of 176 cases were treated with Timolol Maleate Eye Drops as the treatment group, and the 34 cases who received the treatment of "wait and see" was included in the control group. In the treatment group, the gauzes were dipped into the eye drops and putted evenly on the surface of the hemangioma, 3-4 times daily and lasted for more than 20 minutes. The gauze should completely cover the surface of the tumor. The follow-up periods were 3 weeks and 6 months after treatment with the pictures to record the treatment effect. The therapeutic effect was graded as: grade I (unable to control the growth of the hemangioma), II (the growth of the hemangioma stagnated), III (hemangioma significantly subsided), IV (the hemangioma completely disappeared). The effective rate included the cases with grade II and above grade II . The cure cases included the cases with grade IV. The data was analyzed with the statistical software SPSS 17.0 and the Chi-square test (P < 0.05).

RESULTS3 cases in the treatment group showed eczema action. Tumor ulcer happened in 1 case in treatment group. The side effect rate was 2.3% . The results at 3 weeks following in the treatment group showed that the growth of the hemangioma were stagnated in 154 cases. The color of hemangioma became darker in different degrees than before, and the texture of the hemangioma became soft in majority of children, and the thickness of hemangioma became thinner in some cases. However, only 4 cases showed the hemangiomas were subsided, 18 cases showed the color of the part of the hemangiomas were brighter than before, and 12 cases of the hemangiomas remained original state in the control group. The results of 6 weeks following the treatment showed that 18 patients in the treatment group reached the standard of the grade IV, 84 patients reached the standard of the grade III, 60 patients achieved in the standard of grade II, and only 14 patients showed the volume of hemangiomas were increased as grade I. The effective rate was 58. 0% , and the cure rate was 10. 2% in treatment group. In control group, no children reached the standard of the grade IV, 4 cases reached the standard of grade III, 13 cases who remained original state reached the standard of grade II, and 17 cases showed the volume of hemangiomas continued to increase as grade I . The effective rate was 11. 8% , and the cure rate was 0. By comparison, the effective rate and the cure rate in the control group were relatively lower than those in the treatment group (P < 0.05).

CONCLUSIONSThe efficacy of Timolol Maleate Eye Drops in the treatment of superficial infantile hemangioma is exact, especially in the proliferative phase of the infantile hemangioma. It is safe and easy to perform with mild side effect. It should be selected as first-line treatment.

Administration, Topical ; Adrenergic beta-Antagonists ; administration & dosage ; Child ; Hemangioma ; drug therapy ; Humans ; Ophthalmic Solutions ; administration & dosage ; Skin Neoplasms ; drug therapy ; Timolol ; administration & dosage ; adverse effects ; Treatment Outcome ; Watchful Waiting

Dimethylformamide ; poisoning ; Fatal Outcome ; Humans ; Male ; Occupational Exposure ; Young Adult

Electronics ; organization & administration ; Health Promotion ; Humans ; Occupational Health Services

The Delphi method was called into play to determine the level-1 indicator,level-2 indicator and plus-minus indicator for evaluating clinicians of various academic titles,while the ranking method was used to determine the weight of these indicators.The Chi-square test found P＞0.05,proving this indicators system as consistent for clinicians at all levels; the t test found the majority as P＞0.05,indicating the weight of level-2 indicators for dimciam of different titles as different with partial consistence.This system is proved to be scientific,comprehensive,objective and authentic in evaluating clinicians of various levels Targeted evaluation and appraisal system guarantees quality of care and medical safety,which functions as an efficient meansfor better hospital management and better quality of care,paving the wayfor reforms in income distribution system and personnel system in the hospital.

Objective To explore the karyotype distribution in elderly patients with acute leukemia (AL) and compare the prognostic characteristics of karyotype by age grouping.Methods Chromosomal karyotypes were analyzed in 215 cases with AL using the short-term culture of bone marrow cells and G-banding technique.Results There were 202 cases with enough mitosis for analysis and 149 cases(73.8％)with abnormal clone in 215 patients with AL.The rates of abnormal clone were 73.0％ (27/37),74.4％(64/86) and 73.4％ (58/79) in patients aged ≤30,31-59 and ≥60 years,respectively,and no difference were found among age groups (P=0.982).Among 171 patients with acute myeloid leukemia (AML) with detected mitosis,there were 41 better-risk cases (24.0 ％) with most frequent aberration of t(15;17) accounting for 65.9 ％,80 intermediate-risk cases (46.8 ％ ) with principal of normal karyotype accounting for 53.8 ％,and 50 poor-risk cases (29.2 ％)with complex karyotype occupied by 84.0％.The karyotype percentage of better-risk,intermediaterisk and poor-risk were 50.0％,36.4％ and 13.6％ in patients aged ≤30 years,24.3％,48.7％ and 27.0％ in aged 31-59 years,and 16.0％,48.0％ and 36.0％ in aged ≥ 60 years,respectively.The rate of better-risk karyotype was higher in patients aged ≤30 years than the other two groups (P=0.021and P=0.001) and the ratio of poor-risk karyotype higher in patients aged ≥ 60 years than in patients aged ≤30 years (P=0.046).Among 29 patients with acute lymphoblastic leukemia (ALL),10 cases had poor-risk and 19 cases had intermediate-risk karyotype.Conclusions Karyotype analysis provides an important basis for risk assessment and the rate of poor-risk karyotype may increase with the ageing in patients with AML.

BACKGROUND: When central nervous system is injured, re-expression of nestin protein may enhance the anti-injury ability of cells and be advantageous to the repair of focus of injury.OBJECTIVE: To explore the reaction of nerve stem cell (NSC) in permanent brain ischemia through NSC migration and the change of nestin protein expression.DESIGN: A randomized and controlled verification research with experimental animals as subjects.SETTING: Anatomy teaching and research offices in a training school and a university.MATERIALS: The experiment was done in the Teaching and Research Office of Humane Anatomy in Medical College of Xi'an Jiaotong University from October 1999 to January 2001. Totally 75 healthy SD rats were selected and randomly divided into normal control group, experiment group and sham-operation group. Twenty-five animals were in each group. Heads of animals were cut and brain was got out at the 1st, 3rd, 7th, 14th and 28thdays after operation, 5 animals at each time.METHODS: The model was rats with permanent cerebral ischemia. Immunohistochemical dyeing methods were used to observe NSC migration,change of marker of NSC and nestin protein at the 1st, 3rd, 7th, 14th and 28th day after cerebral ischemia.MAIN OUTCOME MEASURES: ①Results of immunohostochemicaldyeing. ②Migration length of nestin+ cells in anterior subentricular zone (SZa) region of brain tissue at normal status and at different time points after cerebral ischemia. ③Number variation of nestin+ cells at different timepoits after ischemia near the ischemic region.RESULTS: Through nestin immunohistochemical dyeing, it was found that NSC in normal brain tissue mainly existed in subependymal zone (SEZ)region. NSC of SEZ migrated in the direction of ischemic region along ventri- corpus callosum after ischemia. Among them, it reached the farthest at the 7th day after ischemia. More nestin+ cells appeared near ischemic region at the 1st day, and then reduced little by little 3 days later.CONCLUSION: NSC has certain reactive ability to ischemic brain injury.Expression of nestin protein near ischemic region may be a kind of protection to injury.

Objective To explore the cytogenetic characteristics of acute myeloid leukemia(AML) patients.Methods The karyotype analysis was performed in 178 AML using the short-term culture of bone marrow cell and G-banding technique.Results Among the 178 patients,171 had enough metaphases for analysis and 128(74.9%)had clonal karyotypic abnormalities.Twenty-seven patients were secondary to myelodysplastic syndrome (MDS-AML),with 25 (92.6%) patients carrying clonal karyotypic abnormalities.Among the remaining 144 patients of de novo AML,103(71.5%)had clonal karyotypic abnormalities.The rate of abnormal clonal karyotype was higher in MDS-AML than that of de novo AML (P=0.021).Among the 171 patients,41(24.0%)were in favorable risk group,80(46.8%)in intermediate risk group and 50(29.2%)in adverse risk group.t(15;17)was the most common chromosomal aberration.The maiority intermediate risk chromosomal aberration was;normal karyotype.The most common cytogenetic abnormality among adverse group was a complex karyotype.Adverse cytogenetic aberrations,such as -5/5q-,-7/7q-,frequently occurred in conjunction with one another as part of a complex karyotype.Totally 75 patients were 60 years or older,among them,16.0%were in favorable risk group,48.0%in intermediate risk group and 36.0%in adverse risk group.Among 96 younger patients,30.2%were in favorable risk group.45.8%in intermediate risk group and 24.0%in adverse risk group.The rate of favorable risk chromosomal aberration was lower in elder patients than in younger(P=0.03 1).The rate of adverse risk chromosomal aberration and the rate of monosomal karyotype were higher in MDSAML than in de novo AML patients(P<0.001).Conclusions The most common favorable,intermediate and adverse chromosomal aberrations were t(15;17),normal karyotype and complex karyotype respectively.The karyotype was poor in MDS-AML and elder AML patients.

Objective This study is based on the physicians'appraisal system upon HIS system to annually assess the associate chief physicians in clinical departments in the mode of attending in charge. Methods 74 doctors above the title of associate chief physician from 14 departments in such mode were selected as objects of study and evaluated upon relative requirement of the performance appraisal index system by means of brainstorming,expert consulting and so on to confirm the content,standard and scoring method of appraisal.Work efficiency index and work amount can be acquired out of HIS system, while details and problems during the assessment can be dealt together with clinical practice.Finally all index and results were collected through HIS system and total scores of relative doctor can be automatically calculated.SPSS 13.0 statistics software also can be used to descriptively analyze the frequency and percentage data.Results The total appraisal scores and scores in every grade of the 74 doctors,who are attending in charge with title above associate chief physician as well as bearing the same responsibility in both medicine and surgery department,were collected,analyzed and respectively ranked respectively.Conclusion The results of appraisal basically indicate general level of the doctors,as well as provide strong evidence for enhancing human resource management of the hospital, which will continuously improve the basis for assessment to performance of associate chief physician under mode of attending in charge,as well as collect experiences for deeply optimizing program of assessment system.

To increase the rescue competency of residents, also the critical thinking, team dynamics, and the capability to handle with emergencies, Shanghai East Hospital developed a rescue course integrated with 24 standardized simulation cases learning and medical simulation education for residents training pro-gram. The instructor candidates should complete the simulation training and pass the instructor certification. Every course was monitored by the course director to ensure the teaching quality. After two and a half years of practice, it is found that the teaching of case teaching and simulation teaching is better than traditional teaching, and it plays an important role in the security of medical security.