Objective To explore the factors influencing the intra-laboratory turnaround time ( ILTAT) and establish a COX regression model.Methods Data of 5 weeks with a total of 904 cases from the samples of blood routine examinations from January 2014 to June 2014 in The Third Hospital of Xingtai were randomly collected.The records of the samples included test dates , times of arrival , times of test , sample statuses, time consumption, time duration, operators, project portfolios, delay, PLT counts, results of 30-minute treatment and test weeks.Based on SPSS 17.0, the above indicators were analyzed by COX single factor analysis and then COX mutiple-factor regression analysis.Results Within the prescribed time , 421 cases were sent taking up 46.6%of the total samples.The ratios of sent cases in 10, 20, 30, 40 and 50 minutes are 10.4%, 24.7%, 46.6%, 58.7% and 82.1% respectively.The results of COX single factor analysis showed that times of arrival , sample statuses, times of examination, operators, project portfolios and delay had statistical significance for ILTAT ( P<0.05 ).The results of COX multiple-factor analysis indicated that right times of arrival had a positive impact in reducing the turnaround time of samples (Wald=40.446,P=0.000);non-office hours, project portfolios, physical check samples, and handovers were unfavorable factors to shorten ILTAT ( Wald =7.904,38.029,42.874,18.617, P =0.005,0.000, 0.000,0.000);Operator 5 was a favorable factor(Wald=11.039, P=0.001) and Operator 3 and Operator 10 were unfavorable factors ( Wald =6.432, 24.242, P =0.011, 0.000 ); no obvious discrepancy was observed for other operators (P>0.05).Conclusions Times of arrival, times of test, operators, project portfolios and delay were the independent risk factors leading to the delay in ILTAT.Other laboratories could determine the variable number of proportional hazards models based on their sample transport , test procedures and principal influence factors , and carry out quantitative evaluation on the factors in sample processing for improvement.Thus, significant decrease on ILTAT would be achieved.

Objective To investigate changes in NF ?B signal pathway in PAM stimulated by lipopolysaccharide(LPS) in vitro , and to explore the molecular pathological mechanism of acute lung injury(ALI). Methods After PAM were stimulated by LPS, the changes in expression of IKK mRNA, activation of NF ?B, degradation of I?B, and secretion of TNF ? in PAM were measured at 0, 15min, 30min, 1h, 2h, and 4h by in situ hybridization, electrophoretic mobility shift assay (EMSA), and enzyme linked immune absorbing analysis (ELISA), respectively. Results The expression of IKK ? mRNA was increased 15min after LPS stimulation and reached the peak at 30 min, then returned to the base line after 1 hour. The changes in I?B ? mRNA were opposite. The activity of NF ?B was increased 15min after LPS stimulation, peaking at 1 hours, and returned to the pre stimulation level after 2 hours. The content of TNF ? was increased initially at 30min, reached the peak at 1 hour, and gradually returned to the pre stimulation level in 2～4 hour. Conclusion The transduction pathway of activation of IKK ? degradation of I?B/activation of NF ?B/synthesization of TNF ? might play a critical role in the molecular pathological mechanism of LPS induced ALI.

Objective To evaluate the anatomic outcome after lens-sparing vitrectomy (LSV) or scleral buckle (SB) for stage 4 retinopathy of prematurity (ROP).Methods The clinical data of 39 infants (50 eyes) with 4a (20 eyes) or 4b (30 eyes) were retrospectively analyzed.The age ranged from two to 18 months,with a mean of (6.0±3.4) months.The gestational age ranged from 26 to 33 weeks,with a mean of (30.0±1.6) weeks.The birth weight ranged from 800 to 1900 g,with a mean of (1404.5±237.6) g.Nineteen eyes underwent SB and 31 eyes underwent LSV.Follow-up ranged from 6 to 84 months,with a mean of (26.0±21.7) months.The anatomical and refractive results were reviewed at the final follow-up.Results The anatomic success of SB was 100.0％ (19 of 19 eyes) and that of LSV was 87.1％ (27 of 31eyes).Among the patients in whom treatment failed,4 were in the LSV group (4/31,12.9％).The buckles of 5 eyes (5/19,26.3％) were removed.At the end of the follow-up,the mean myopic refraction was (-4.46±2.49) diopters (ranging from -1.25 to 11.00 diopters) in the LSV group,and ( -3.21±1.96) diopters (ranging from -1.25 to 9.25 diopters) in the SB group.There was no significant difference between two groups (F=2.76,P=0.103).Conclusion The anatomic outcome after LSV or SB for stage 4 ROP was excellent.

Objective To compare the efficacy and safety of laser photocoagulation and intravitreal injection of bevacizumab for stage 3 retinopathy of prematurity (ROP).Methods The study included 38eyes of 19 infants with stage 3 ROP (18 eyes of 9 infants in zone Ⅰ,20 eyes of 10 infants in zone Ⅱ ).All the patients were examined by indirect ophthalmoscope and photographed by wide-angle digital retinal imaging system (RetCam Ⅱ ). The fundus lesions in both eyes were the same. Patients received laser photocoagulation in one eye (laser group) and intravitreal injection of 0.03 ml bevacizumab (25 mg/ml) in the fellow eyes (bevacizumab group) during treatment.Follow-up ranged from 12 to 66 weeks,with an average of 33 weeks. The regression time of neovascular ridges and plus-diseases in two groups were compared.Results For 18 eyes with stage 3 ROP in zone Ⅰ,the regression time of neovascular ridges and plus-diseases were (2.25 ±0.46) and (2.11 ±0.60) weeks respectively in bevacizumab group,and both were (3.75 ± 1.75) weeks in laser group.The differences between those two groups were statistically significant (F=18.29,15.56；P＜0.05).For 20 eyes with stage 3 ROP in zone Ⅱ,the regression time of neovascular ridges and plus-diseases were (3.1 ±1.72) and (2.1 ± 0.56) weeks respectively in bevacizumab group,and were (3.50± 1.90) and (2.50± 1.35) weeks respectively in laser group.The differences between those two groups were not statistically significant (F =0.38,2.62 ; P＞ 0.05).There were more fibrous membrane proliferations on the retinal surface in 8 eyes,including 6 eyes in laser group and 2 eyes in bevacizumab group. There was no treatment-related endophthalmitis,cataract,retinal tears and other complications during the follow-up.Conclusion The laser photocoagulation and intravitreal injection of bevacizumab were both safe and effective in treating stage 3 ROP.

Objective To investigate the prognostic factors of life and functional outcome of the first hemiparetic stroke patients. Methods One hundred and eighteen stroke subjects were registered prospectively. The Barthel index (BI) , Rankin scale (RS) , Mortricity index(MI) , Mini-mental state examination (MMSE) , Montgomery-Asberg depression scale (MADRS) and a scale of general state and risk factors were used to evaluate at the 48th hour, the 15th day and the 90th day after stroke. Results The patients' performance, as demonstrated by their scores with all the evaluation instruments, changed significantly at all the time points of evaluation after stroke (P ＜0.05). There was no significant difference between the performance at the 48th hour and the 15th day after stroke ( P ＞ 0.05 ). But at the 90th day after stroke, the activity of daily living performance and the depression status recovered significantly (P ＜ 0.01 ). Logistic regression analysis showed that, such factors as pneumonia, urinary incontinence within 48th hour and deep sensation disturbance might adversely influence patients' activity of daily living performance at the 90th day after stroke; the muscle strength of upper extremities at the 48th hour, and MMSE scores at the 15th day after stroke acted as the protective factors. Conclusions The stroke patients improved significantly with regard to their clinical and functional manifestations when evaluated 90 days after stroke onset. The main factors influencing the activity of daily living performance 90 days after stroke onset included deep sensation disturbance,pneumonia, urinary incontinence and muscles strength of upper extremities at 48th hour, and MMSE scores at the 15th days after onset.

BACKGROUND:Ful-thickness articular cartilage injury is notoriously difficult to be treated in the fields of orthopedics and sports medicine. Al ogeneic bone and cartilage transplantation can offer a transparent cartilage with biological activity and biomechanical properties to repair ful-thickness articular cartilage defects. Al ogeneic osteochondral grafts from osteochondral tissue bank are adequate, and have a good prospect in the treatment of articular cartilage defects.
OBJECTIVE:To summarize the drawn materials, preservation, quality control and clinical monitoring of al ogeneic osteochondral grafts supported by the osteochondral tissue bank.
METHODS:The first author searched PubMed and CNKI for the relevant articles published before 2013 using the key words of“tissue bank, knee, articular cartilage, preservation, transplantation”in English and Chinese, respectively. After retrieval, we summarized the drawn materials, preservation, quality control and clinical monitoring of al ogeneic osteochondral grafts supported by the osteochondral tissue bank.
RESULTS AND CONCLUSION:Nineteen of 194 retrieved articles were enrol ed according to inclusive and exclusive criteria. The results show that al ogeneic bone and cartilage transplantation is an ef ective method for the treatment of articular cartilage defects, and the establishment of the osteochondral tissue bank can provide safe and active tissues for the treatment of articular cartilage defects. Now, the osteochondral tissue bank is stil in the initial stage.

AIM:To compare the effects of atorvastatin at different doses on the function of endothelial proge-nitor cells (EPCs) in the patients with ST-segment elevation myocardial infarction (STEMI).METHODS:The patients of STEMI (n=40) were chosen.According to treatment with different doses of atorvastatin calcium tablet, they were randomly divided into a group of 20 mg and a group of 40 mg (20 cases in each group).The EPCs isolated from the patients were identified and quantitatively analyzed at different time points (before the treatment and on days 5, 10, 15, 20, 30, 60, 90 and 120 after the treatment) by flow cytometry.The surface markers of the EPCs, CXC chemokine receptor 4 (CXCR4), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and silent information regulator 1 (SIRT1), were also detected.RESULTS:On the 5th day, the group of 40 mg demonstrated stronger cell proliferation capability and higher expression levels of CXCR4, VEGF and bFGF than the group of 20 mg (P<0.05).From the 10th day to 120th day, the group of 20 mg revealed stronger cell proliferation capability and higher expression levels of CXCR4, VEGF and bFGF than the group of 40 mg (P<0.05).Within 30 d, the expression of SIRT1 showed no significant diffe-rence between the 2 groups, yet it witnessed a marked change after that and peaked on the 60th day with a drop afterwards.At each time point, the SIRT1 expression level in the group 20 mg was observed higher than that in the group of 40 mg (P<0.05).CONCLUSION:In the acute phase, the repair function of the body treated with atorvastatin at dose of 40 mg is better than that with 20 mg.However, in a long term the low concentration of statin therapy works better in improving the vascular intima and promoting the angiogenesis than high concentration.

Objective To retrospectively analyze adverse drug reaction ( ADR ) of Yuxingcao ( Houttuyniae Herba ) preparations, thus provide reference for post-market re-evaluation of traditional Chinese medicine injections. Methods The ADR from Chinese ADR spontaneous reporting system database from 2006 to 2008 were analyzed by descriptive statistic method. Results A total of 2 282 reports on ADR induced by Yuxingcao preparations were concluded in this study, and 98.07% ADR of the total cases ( 2 238 case ) were due to vein injection. The main ADR were anaphylactic reactions which injure multiple systems and organs.The most frequent symptoms were respiratory system damage, such as expiratory dyspnea (with the incidence rate of 27.25%).Skin and mucous membrane were the secondly susceptible (with the incidence rate of 21.35%).The ratio of serious ADR in the total case was 13.50% (308 case), rate of allergic shock was 8.37% (191 case), and 22 cases were dead. Conclusion By strengthening the ADR reporting and monitoring, the risk of traditional Chinese medicine injection could be controlled.Safety re-evaluation should be performed to overall enhance safety, effectiveness and quality control of these kinds of medicine.

Objective To observe visual field outcome and refractive status of patients with retinopathy of prematurity (ROP) treated by laser photocoagulation.Method The data of 39 ROP patients (73 eyes) who received laser photocoagulation were retrospectively analyzed and compared with 13 normal control subjects (25 eyes) whose age and sex were matched with ROP group.There were 24 males (45 eyes) and 15 females (28 eyes) in ROP group,with an average age of (7.0± 1.28) years.The first laser treatment was carried out at postnatal age (PA) of (38.74±3.82) weeks,the birth weight (BW) of (1402.33 ±369.61) g and the number of laser burns was (517.86 ± 277.40).The control group included 7 females (13 eyes) and 6 males (12 eyes),with an average age of (7.17 ± 0.96) years.The age (t=0.691) and gender (x2=1.425) were comparable between the two groups (P=0.491,0.233).The data of patients and controls were retrospectively analyzed including best corrected visual acuity,refractive examination,automated perimetry test.The differences of the mean deviation (MD) of visual field and the spherical equivalent (SE) between these two groups were comparatively observed.ROP patients were divided into no VF loss group (MD≤2 dB) and VF loss group (MD＞2 dB),mild VF loss group (MD ≤ 6 dB) and moderate VF loss group (MD ＞6 dB) according to the results of automated perimetry test,the differences of gestational age (GA),PA,BW,number of laser burns and SE between these groups were comparatively observed.Results The MD in ROP group and control group were 4.87±5.12 dB and 1.27 ± 3.34 dB,respectively;the difference between the two groups was statistically significant (t=-4.01,P＜ 0.001).The subgroup analysis showed that BW,number of laser burns,and SE were significantly different between no VF loss group and VF loss group (t=2.074,-1.996,-2.162;P=0.042,0.026,0.034);while the GA was not significantly different between these two groups (t=1.973,P=0.052).The difference of PA was not statistical significant different between mild VF loss group and moderate VF loss group (t=2.03,P=0.051) and SE was significantly different between the above two groups (t=3.283,P=0.002).For refractive outcomes,the BW and ROP stage correlated with SE significantly (r=-0.304,-0.387;P=0.015,0.002).The mean BCVA in ROP group was 0.84±0.23,and 59 eyes (91.2％) with BCVA better than 0.5.Conclusion Laser treatment for ROP tends to have less effect on long term refractive status and VF loss,with good visual outcome.

Objective To observe the surgical effects of scleral buckling and vitrectomy for familial exudative vitreoretinopathy (FEVR).Methods 34 eyes of 27 patients with FEVR who underwent either scleral buckling or vitrectomy were enrolled in this study.There are stage 2B in 2 eyes (5.88％),stage 3B in 7 eyes (20.59％),stage4Ain 1 eye (2.94％),stage4Bin 16 eyes (47.06％),stage 5 in8 eyes (23.53％).5 eyes associated with rhegmatogenous retinal detachment.The surgical approaches had been chosen according to the disease stage,severity,extent and morphology of the proliferative membrane.13 eyes (stage 2B in 2 eyes,3B in 4 eyes,and 4 in 7 eyes) underwent scleral buckling and 21 eyes (stage 3B in 3 eyes,4 in 10eyes,and 5 in 8 eyes) underwent vitreoretinal surgery.The main outcome measurement was the anatomic status of the macula,which was recorded as attached,partially attached or remain detached.The mean follow up was (18.00 ± 14.61) months (range 4 to 60 months).Results Among 13 eyes received scleral buckling,the macula was attached in 2 eyes with stage 2B (15.38％),partially attached in 11 eyes (84.62％) including 4 eyes with stage 3B,1 eye with stage 4A and 6 eyes with stage 4B.Among 21 eyes received vitrectomy,the macula was attached in 8 eyes (38.10％) including 2 eyes with stage 3B,4 eyes with stage 4 and 2 eyes with stage 5;the macula was partially attached in 9 eyes (42.86 ％) inducing 4 eyes with stage 4 and 5 eyes with stage 5;the macula remained detached in 4 eyes (19.05％) including 1 eye with stage 3B,2 eyes with stage 4 and 1 eye with stage 5.Conclusion If the surgical approaches were chosen based on the stage of FEVR and the severity,extent and morphology of the proliferative membrane,the surgery is effective and beneficial to FEVR patients.