The paper is to investigate eco-design flaws in equipments for medical simulation training and explore methods to improve. The eco-design flaws in equipments for medical simulation training were elaborated from the aspects of accessories, modules, model volumes, recycling of waste equipments, and production materials. The improved methods of the flaws were demonstrated. The designs of equipments for medical simulation training can be more environment friendly by means of getting rid of unnecessary accessories, developing replaceable modules for manikin models, curtailing volumes of equipments, recycling waste equipment and using degradable production materials. As the tendency of being environment friendly in medical equipments becomes increasingly obvious, the eco-friend merits must be considered by multi-objective optimizations in the processes of design, manufacture, and employment of equipments for medical simulation training.

Animals ; Diazepam ; pharmacology ; Drug Antagonism ; Electroencephalography ; Female ; Male ; Pyrazoles ; poisoning ; toxicity ; Rats ; Rats, Sprague-Dawley

Hemoperfusion ; Humans ; Ivermectin ; analogs & derivatives ; poisoning ; Liver Cirrhosis ; complications ; therapy ; Male ; Middle Aged

Adolescent ; Adult ; Aged ; Batroxobin ; therapeutic use ; Double-Blind Method ; Female ; Fibrinolytic Agents ; therapeutic use ; Hearing Loss, Sudden ; drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Young Adult

Objective To evaluate the feasibility and efficiency of laparoscopic-guided radiofrequency ablation on advanced prostate cancer.Methods From March 2003 to December 2008,a total of 6 previous prostate cancer patients who had been diagnosed with pathological results were treated by laparoscopic-guided radiofrequency ablation.All patients underwent pre-and post-operative IPSS,serum PSA,MRI and normal blood biochemistry examination.The treatment outcome,surgery-related complications were also recorded.Results All operations were successfully completed,no serious intra-and post-operative complications happened.Although there was no significant difference of IPSS between pre-operative [ ( 19.05 + 4.28 ) scores ] and 1 month after operation [ ( 19.87 + 5.72) scores ],but there were significantly decreased in 3 months [ (9.45 ± 2.03 ) scores ] and 6 months [ (6.18 + 1.79) scores ] after operation (P ＜0.05).Also being followed up to 6 months after operation,the serum PSA was significantly decreased compared with the pre-operative value [from(24.80 ± 14.56) μ g/L reduced to( 13.79 ± 7.76) μ g/L](P＜0.05).Conclusion Laparoscopic-guided radiofrequency ablation on advanced prostate cancer is safe and feasible,and can be used as an effective treatment in selective cases.

Objective To investigate the morphological changes of bone marrow megakaryocytes in patients with bacterial and fungal infection.Methods Totally 76 patients with microorganism infection from the Second Affiliated Hospital,Zhejiang University School of Medicine from January 2008 to August 2009 were enrolled,including 56 bacteria infected patients and 20 fungal infected patients.All patients received bone marrow examinations,and were positive in microorganism culture.Thirty subjects without infection,hematological disease and other severe diseases were randomly selected as controls.The number and function of megakaryocytes were examined retrospectively, and the size, nuclear lobulation, and vacuolar degeneration of megakaryocytes were quantitative analyzed and compared among the groups.Results The size,nuclear lobulation,vacuolar degeneration,and Yat nuclear of megakaryocytes in bacterial infected group were 2.20 ±0.21,2.11 ±0.23,0.51 ±0.11 and 0.74 ±0.11 respectively,those in fungal infected group were 2.21 ±0.16,2.10 ±0.19,0.52 ±0.10 and 0.79 ±0.10 respectively;while those in control group were 1.40 ±0.10,1.36 ±0.12,0.28 ±0.06 and 0.54 ±0.09 respectively.The differences between bacterial infected group and control were of statistical significance(t values were 14.52,12.19,9.33 and 6.61 respectively,P ＜ 0.05),and the differences between fungal infected group and control were of statistical significance(t values were 16.27,12.34,7.85 and 6.49 respectively,P ＜ 0.05).The size,nuclear lobulation,and vacuoles of megakaryocytes in gram-negative(G-)bacteria group were 2.29 ±0.20,2.22 ±0.26 and 0.57 ±0.10,while those in the gram-positive(G+)bacteria group were 2.13 ±0.20,2.04 ±0.18 and 0.46 ±0.09,and the differences were also significant(t values were 2.07,3.03and 3.56 respectively,P ＜ 0.05).The production of platelet by megakaryocytes in bacterial infected group,in fungal infected and the control were 31.4 ±7.6,32.4 ±6.4 and 41.3 ±5.5,and the differences between bacterial infected group and control,fungal infected group and control were significant(t values were 4.78and 3.98 respectively,P ＜ 0.05).The production of platelet in G-bacteria group was 28.0 ± 6.7,while that in G + bacteria group was 34.4 ± 7.2,and the difference was also of statistical significance(t = 2.41,P ＜0.05). Conclusion Bacterial infected patients have increased megakaryocytes cell body,nuclear lobulation,obvious vacuolar degeneration,Yat nuclear and decreased platelet production function,which are more significant in G- bacteria infected group.

Objective To evaluate the effects of serum procalcitonin (PCT)-guided antibiotic therapy in elderly patients with early-onset stroke-associated pneumonia (EOP).Methods Totally 179 eligible elderly patients with EOP were randomly devided into 2 groups:standard therapy group (standard group,n=88) and PCT-guided group (PCT group,n=91).Patients in standard group received antibiotics according to antibiotics guidelines in China by the treating physicians.Patients in PCT group were treated with antibiotics for 5 days,then the antibiotic treatment was based on serum PCT levels as follows:discouraged if PCT＜0.25 μg/L and encouraged if PCT≥0.25 μg/L.Length of hospitalization,duration of antibiotics,costs of hospitalization and antibiotics,clinical efficacy,andmortality,National Institutes of Health Stroke Scale (NIHSS) score and Barthel index (BI) on the 28th day were observed.Results There were no significant differences in clinical efficacy,mortality,NIHSS score and BI between the two groups on the 28th day [(85.7％ vs.86.3％),(8.8％ vs.7.9％),10.1 (7.8,16.2) vs.9.8 (6.0,15.5),60.1(42.5,82.3) vs.57.9 (39.2,84.8),respectively,all P＞ 0.05].The length of hospitalization,antibiotic duration,costs of hospitalization and antibiotics were lower in PCT group than in standard group [19 (10,38) d vs.26(17,42) d,10 (7,14) dvs.15 (6,21) d,3350 (2052,6163) yuanvs.10355 (6877,15421) yuan,7532 (4810,12116) yuan vs.5358 (3089,8144) yuan,respectively,all P＜0.05].Conclusions PCT guidance of antibiotic therapy is effective and safe for the treatment of early-onset stroke associated pneumonia in elderly patients.It can reduce the antibiotic duration and costs of hospitalization.

Objective To explore the activition and polarization of microglia in the epileptic rats induced by lithium chloride-pilocarpine. Methods One hundred male SD rats were randomly divided into five groups: control group and different time points model groups including 1d,3d,7d and 14d. Epilepsy models were established by lithium chloride-pilocarpine intraperitoneal injection. The control group was given the same dosage of normal saline. The morphology change was detected by immunofluorescence,and the expressions of iNOS and Arg-1 were determined by IHC at respective time points. Results Compared the model groups with control group,microglia was activated,synapsis was shorten,volume got bigger,most of them seemed as amoebocyte,the expression of iNOS increased and Arg-1 decreased,especially at 3d.ConclusionThe results from this study indicated that microglia was activated and polarized in epileptic rats induced by pilocarpine.

Objective To explo the antioxidant effect and molecular mechanism of gastrodin (Gas) in epilepsy (EP) rats induced by LiCl-pilocarpine (PILO) . Methods Eighty male SD rats were randomly divided into 5 groups: sham group, EP group, therapy groups (pretreated with 60 mg/kg, 90 mg/kg, 120 mg/kg of gastrodin respectively) . The EP model was esteblished by peritoneal injection of LiCl-PILO. Therapy groups were pretreated with various concerntration of Gas. The control group was given the same dosage of normal saline. The alteration of behavior was observed, the concentration of catalase (CAT), glutathion (GSH), superoxide dismutase (SOD), glutathion reductase (GR), total antioxidtion (T-AOC) and malondialdehyde (MDA) in rats brain cortex were detected by chemical colorimetric method, phosphorylation of p38 was determined by western blot. Results There was no EP seizure in sham group,and the EP seizure degree in therapy groups (gas pretreated groups) was significantly decreased,and had statistically significant difference with EP group (P<0.05) . The EP model rats exhibited a significant decrease in the concentration of endogenous antioxidants (CAT, GSH, SOD, GR and T-AOC), while an increase of the concentration of MDA and phosphorylation p38 protein as compared to sham group (P<0.05) . After treatment of the Gas,treatment group rats attenuated the seizure degree,exhibited a significant increase of the concentration of endogenous antioxidants (P<0.05),while a decrease in concentration of MDA and phosphorylation of p38 as compared to model group (P<0.05) . Conclusion Gas may have a neuroprotective role in central nervous system of epileptic rats modle by down-regulateing the seizure degree and the activity of p38 kinase and up-regulateing the content of endogenous antioxidants.

OBJECTIVETo observe the efficacy of integrative Chinese and western medicine (ICWM) in treating diabetic foot.

METHODSSixty-three patients were randomly divided into the treated group (n = 33) and the control group (n = 30). Both groups were treated by same baseline treatment with vasodilator, anti-agglutination agents and external treatment, to the treated group, Chinese drugs were given additionally according to the Syndrome Differentiation.

RESULTSIn the treated group, the treatment showed markedly effective in 12 patients, effective in 18 and ineffective in 3, the total effective rate being 90.0%, while in the control group, the corresponding numbers were 9, 14, 7 and 76.7%, comparison between the two groups showed significant difference (chi 2 = 15.8, P < 0.05). The case number of Grade II, III and IV in the treated group reduced, and those recovered to Grade 0 increased, as compared with those in the control group, the difference was significant (P < 0.05). Patients with healing of ulcerative wound and fresh wound granulation in the treated group, as compared with those in the control group, the difference was significant (P < 0.05). Levels of fasting blood glucose and blood glucose 2 hrs after meal were all improved in both groups, which showed significant difference as compared with those before treatment (P < 0.05).

CONCLUSIONThe efficacy of ICWM treatment in treating diabetic foot was better than the treatment of western medicine alone.

Aged ; Combined Modality Therapy ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Foot ; drug therapy ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Insulin ; therapeutic use ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Scopolamine Hydrobromide ; therapeutic use