BACKGROUND:In recent years, interventional therapy because of its high success rate, good curative effect, little trauma has been widely recognized, but vascular intimal injury due to interventional therapy stil has no effective treatment, resulting in long-term postoperative severe restenosis. Stem cel transplantation has brought a new drawn for the repair of impaired endothelial function, reendothelialization and aided restoration of the blood supply to ischemic tissues. OBJECTIVE: To summarize the recent progress in umbilical cord blood stem cels transplantation and endovascular treatment for treatment of diabetic lower limb ischemic disease. METHODS: A computer-based search of PubMed and CNKI was performed for relevant articles published from January 2000 to March 2015 using the keywords of “umbilical cord blood stem cel transplantation, percutaneous transluminal angioplasty, diabetic lower limb ischemia, restenosis” in English and Chinese. Totaly 216 relevant literatures were initialy obtained, and 44 articles were ultimately included. RESULTS AND CONCLUSION:By comparing the therapeutic efficacy and long-term prognosis of umbilical cord blood stem cel transplantation and endovascular treatment, it is concluded that umbilical cord blood stem cel transplantation combined with endovascular treatment is better than either of them alone, which can promote the establishment of colateral circulation, improve the impaired endothelial function and reduce the occurrence of restenosis after interventional therapy.

Objective To investigate the clinical application of Fibroscan to noninvasive detection of liver fibrosis in asymp‐tomatic carriers(ASCs)with chronic hepatitis B virus(HBV).Methods Clinical data of 195 chronic HBV ASCs were retrospec‐tively analyzed ,including liver function ,HBV DNA quantitation ,liver stiffness(LS) ,color Doppler ultrasound results of the liver and spleen and histopathological findings of the liver.LS was evaluated by transient elastography(Fibroscan).Liver biopsy was performed in 80 carriers for histological examination.Results The LS value was(6.22 ± 2.50)kPa in 195 cases.There was no significant difference in the LS value between HBV DNA <500 copies/mL and HBV DNA≥500 copies/mL groups.The LS value in patients with HBV carrying duration>15 years was significantly higher than that in patients with HBV carrying dura‐tion≤5 years(P<0.01).It was (6.72 ± 2.33) kPa in patients(n=49)with liver tissue inflammation and necrosis

OBJECTIVE:To improve the safety management level of high-risk drug Insulin injection in our hospital. METH-ODS:The standard management of Insulin injection(400 u/injection)was conducted by using PDCA(plan-do-check-action). The application of Insulin injection in wards was compared before and after six months of management. RESULTS:By strengthening training,improving ward baseline insulin management register system,adjusting the specification of insulin in information system, etc.,the application and storage of insulin became more standard;no expired drugs occurred;the rate of waste drug decreased from 95.06% before management to 22.00% after management,decreasing by 73.06%. CONCLUSIONS:PDCA cycle can im-prove the safety management of Insulin injection in wards effectively.

ObjectiveTo explore the treatment efficacy and feasibility of large dose of cytidine diphosphate choline (CDPC) in cardiopulmonary cerebral resuscitation.MethodsOne hundred and thirtytwo patients with sudden cardiac arrest successfully treated by the cardiopulmonary cerebral resuscitation were divided into treatment group ( 75 patients) and control group (57 patients) by random number tables.Two groups of patients were given adrenaline resuscitation drugs,reducing the intracranial pressure drugs,hypothermia,hormones and other basic treatment.Control group used CDPC 0.25 g with glucoseinjection 300 ml to do intravenous drip (once a day,21 days as a period of treatment),and treatment group added CDPC to 2.00 g.The patients were treated by basic traditional analeptic.The Glasgow coma scale (GCS) was carried out in two groups in admission to hospital and 3,7,14,21 days after treatment,and the changes of lysophosphatidic acid (LPA) and phosphatidic acid (AP) level were monitored.ResultsThe GCS score was significantly higher in treatment group 7,14,21 days after treatment(P ＜ 0.05 or ＜ 0.01 ),but GCS score had no significant difference before and after treatment in control group(P ＞ 0.05).The level of LPA in treatment group was significantly decreased 14 days after treatment [ (2.98 ± 0.28) μmol/L ] and 21 days after treatment[ (1.85 ± 0.21)μmol/L],and had significant difference compared with that admission to hospital [ (3.75 ± 0.22) μ mol/L ] (P ＜ 0.05 or ＜ 0.01 ).In control group,there was no significant difference before and after treatment (P ＞0.05).The level of AP in treatment group 21 days after treatment was significantly decreased compared with that in control group [ ( 3.45 ± 0.23 ) μ mol/L vs.( 5.20 ± 0.21 ) μ mol/L ](P ＜ 0.01).ConclusionLarge dose of CDPC can improve neurological function of cardiopulmonary cerebral resuscitation,which is a safe,effective and easy way to be popularized.

OBJECTIVE:To observe therapeutic efficacy of Rhodiola wallichiana injection for swelling and pain in fracture pa-tients during perioperative period. METHODS:120 patients with closed fresh extremity long bones fracture were randomly divided into trial group and control group,with 60 cases in each group. Both groups received open reduction and plate fixation. Before and after op-eration,control group was given routine medicine and anti-inflammatory treatment;trial group was additionally given R. wallichiana in-jection 10 ml(250 ml added into 5%Glucose injection)intravenously,qd,on the basis of control group. A treatment course lasted for 10 d. The swelling degree before operation,1 d and 3 d after operation,pain degree on the day of operation and 1,2,3 and 7 d after operation,complication and average length of stay were observed and compared between 2 groups. RESULTS:The extent of swelling and pain,the incidence of complications and average hospitalization days of trial group were lower or shorter than control group,with statistical significance (P<0.05). CONCLUSIONS:R. wallichiana injection can promote blood circulation and remove blood stasis, ease the hydropsia and pain,relieve swelling and pain,reduce the incidence of complications and shorten hospitalization day.

Objective To understand the functional status and radiation protection requirements of helical tomotherapy (TOMO) unit when it is applied in clinic treatment so as to promote the construction of TOMO quality control system.Methods A helical tomotherapy unit with a type of tomotherapy Hi-Art was employed as the radiotherapy unit.A series of tests and analyses on dosimetric and radiation safety performance parameters of the TOMO unit were conducted with the use of a A1SL ionization chamber,a set of solid water equivalent phantoms and other test equipments.The performance parameters were compared with that of a conventional 6 MV accelerator with a type of ARTISTE.Results The deviations of static and dynamic output dose were-1.51％ and 1.18％,respectively.The values of PDD10/PDD1.5 and PDD20/PDD1.5 were 0.608 and 0.318 within the range of X-ray quality parameters calibration.Under the different field conditions of 40 cm × 5 cm,40 cm × 2.5 cm and 40 cm × 1 cm,the stability of transverse/longitudinal dose distribution curve was no more than 1.20％ and the offset distance of Jaw width was smaller than 0.5 mm.Radiation leakage ratio of the treatment rotating center from the muhileaf collimator (MLC) was 0.20％.No matter the average or the maximum value of the leakage radiation from couch plane was less than 0.02％.Conclusions The performances and testing requirements of TOMO unit are different from a conventional electron linear accelerator,the quality control index of TOMO unit should be set seperately and tested strictly in terms of the specific requirements of the unit by complying with the QC programme.The reliable quality control system should be established and effectively implemented to serve the radiotherapy quality and radiation safety effectively in the tomotherapy.

Objective To evaluate the relationship between the anesthesia factor and myocardial injury in the patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).Methods Eightyeight patients of both sexes,aged 42-71 yr,weighing 59-83 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),scheduled for elective coronary artery bypass grafting with CPB,were divided into 4 groups (n =22 each) using a random number table:routine anesthesia control group (group C),dexmedetomidine-based anesthesia group (group D),sevofluranebased anesthesia group (group S) and dexmedetomidine combined with sevoflurane anesthesia group (group DS).After tracheal intubation,0.2％-2.1％ sevoflurane was inhaled until the beginning of CPB in S and DS groups.In D and DS groups,dexmedetomidine was intravenously infused as a loading dose of 1 μg/kg over 10 min before induction of anesthesia,followed by an infusion of 0.4 μg · kg-1 · h-1 until the end of surgery.Before induction of anesthesia,before CPB,after the end of CPB,immediately after the end of surgery and at 24 h after surgery,venous blood samples were collected for determination of plasma creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) concentrations by immunofluorescence.The restoration of spontaneous heart beat and adverse events such as hypotension,malignant arrhythmia,cardiac arrest and respiratory depression during surgery and within 24 h after surgery were recorded.Results Compared with group C,the plasma concentrations of CK-MB and cTnI were significantly decreased in the other three groups (P＜0.05).The plasma eoncentrations of CK-MB and eTnl were significantly lower in group DS than in S and D groups (P＜0.05).There were no significant differences in the rate of restoration of spontaneous heart beat among the four groups (P＞ 0.05).No adverse events were found during surgery and within 24 h after surgery in the four groups.Conclusion Dexmedetomidine combined with sevoflurane anesthesia is helpful in reducing myocardial injury and provides better efficacy than either alone in the patients undergoing cardiac surgery with CPB and is more suitable for cardiac surgery with CPB.

The noninvasive measurement of liver stiffness (LS) was evaluated by transient elastography (FibroScan) and the possible influencing factors from the patients' clinical situations including age, gender, liver inflammation represented by alanine transaminase (ALT) and total billirubin (TBIL) level, HBV replication (HBV DNA loads), portal vein pressure (portal vessel diameter, PVD), splenic thickness (SPT) and body mass index (BMI) were analyzed in patients with chronic hepatitis B (CHB). A total of 466 patients including 31 patients with acute-on-chronic liver failure (ACLF), and 435 patients with chronic hepatitis B (CHB) among which 82 patients were diagnosed with liver cirrhosis (LC) by clinical manifestations and liver B-type ultrasonic inspection were enrolled at Tongji Hospital from April to December 2009. LS was measured by a FibroScan device (EchoSens, France). Simultaneously, ALT and TBIL levels, HBV DNA loads, PVD, SPT and BMI in all patients were also tested. Forty-one healthy volunteers served as controls. The values of LS were correlated positively with ages of CHB patients and significantly higher in males than in females. In patients with BMI>28 kg/m(2) (obesity) and abnormal levels of ALT and TBIL, LS values were significantly increased as compared with those having normal levels of ALT and TBIL. The patients with ACLF had the highest LS value. Furthermore, LS values in the patients with LC were significantly higher than those in patients without LC. It is concluded that noninvasive measurement of liver fibrosis by FibroScan provides an alternative method to evaluate liver fibrosis of patients with CHB. In order to properly illustrate the stiffness value taken by transient elastography, patients' gender should be taken into consideration and it is also suggested to avoid possible influencing factors including liver inflammation (high levels of ALT and TBIL) and obesity (high BMI).

Objective To investigate the effects of early tracheotomy on the prognosis of patients with severe brain lesions .Methods The clinical data of 68 patients with severe brain lesions were retrospectively analyzed . According to the time of tracheotomy ,we assigned 68 patients to receive either early tracheotomy or late tracheotomy . 34 patients who were given tracheotomy within 72 hours in Intensive Care Unit were selected as the early tracheotomy group (ET group).34 patients who were given tracheotomy after 14 days in Intensive Care Unit were selected as the late tracheotomy group(LT group).The time of mechanical ventilation,length of hospital stay,and the incidence of ventilator associated pneumonia ( VAP ) , sedative drug use time , antibiotic use time , in-hospital mortality were compared between the two groups.Results In ET group,the hospitalization time,mechanical ventilation time, incidence of VAP,sedative drug use time,antibiotic use time were (4.2 ±2.4)d,(3.5 ±0.6)d,(14.5 ±3.2)%, (1.5 ±0.5)d,(3.3 ±0.3)d,those in LT group were (12.5 ±4.8)d,(8.5 ±5.6)d,(28.6 ±8.6)%,(6.3 ±1.2)d, (13.2 ±1.1) d respectively,the differences between the two groups were statistically significant ( t =3.14,2.96, 3.28,3.46,2.57,all P<0.05).The hospitalization mortality rates of ET group ,LT group were (23.8 ±4.38)%, (24.5 ±4.16)%,respectively no significant difference between the two groups ( t=1.49,P<0.05).Conclusion The use of early tracheotomy can reduce the hospitalization time ,shorten the time of mechanical ventilation ,reduce the incidence of ventilator associated pneumonia ,and reduce the time of using sedative drugs and antibiotics ,but the mor-tality has no significant effect in the severe craniocerebral injury patients .

Aim To provide an electrophysiological basis for hippocampus involved emotional changes caused by tinnitus, the effects of salicylate on electro-physiological characteristics of the voltage-gated calci-um channels in hippocampal neurons were performed. Method The effects of salicylate on voltage-gated cal-cium channels in rat hippocampal neurons were stud-ied, using the whole-cell voltage clamp method. Re-sults Salicylate blocked the voltage-gated calcium channels ( ICa ) in a concentration-dependent manner (0.1~10 mmol · L-1 ) . The half-inhibition concen-tration ( IC50 ) values for the blocking action of salicy-late on ICa were 1.64 mmol·L-1 . With 1 mmol·L-1 salicylate applicalted into bath solution, the steady-state activation curve of calcium channel was shifted by about 9 mV in the hyperpolarizing direction, and its steady-state inactivation curve was not changed. Con-clusion Salicylate inhibits ICa in rat hippocampal neu-rons and significantly affects the activation kinetics of ICa ,which could be related to emotional changes caused by tinnitus.